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Stuart & Corinne Peterson Tst_ 56000030013000_Shoreland Permits_
WHITE - Office GQLDENRO'O - Inspector APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tall.mn.us VELLOW - Owner (after issue) PINK - Assessor Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO. 3?S' LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME o y//3SO' PARCEL NUMBER (S) S6 OOOOI3O Of*/Oo0 S'lOOOr? JCt>0 £CCC >PROPERTY (E-911) ADDRESS ses-j:? ------------------------/aeroLEGAL DESCRIPTION Last Name First Initial Mailing Address Daytime Phone No. ■3 Of-. 7>/7/ SC52 2^4tai r'f rProperty Owner 1iR^ierSp./\ C<gr/nAg g.7 9^ Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling (4 ) MH/YR (7) Add’n To Non-Dweiiing (10 ) Non-Conf. Replacement (identify)"________*<_____________________^ (11) Other (identify) A^ArA£ (12 ) Deck_______________________________________________________ ONSITE WATER SUPPLY pl(f Individual ( ) Public ( ) None NOTE: MN Rules Chpt, 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM(2 ) Add’n to Dwelling (5 ) RCU/Year______ (8) Storage Structure (3 ) Replacement Dwelling* (6) Attached / Detached Garage (9) W.O.A.S.( ) Permit No. ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Roltie Mann at 218-864-5533 ‘Removal of Existing Dwelling Verified by L&R "Existing Non-Conf. Structure Verified by L&R Inspector's Initial/Date Inspector's Initial/Date CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must lt)clude Attached Garage) Outside Dimension___ Sq. Ft. \ Setback to Lotlirte ____ Setback to Right orWay Setback to Ordinary l^h Water l^el ___ Elevation Above Ordinar^igh Water Level Setback to Septic Tank___ Setback to Drainfield___J Setback to Bluff / Total Bedrooms / Maximum Proposed Height Roof Change (/) Yes ( ) No \ Basement (/ ) Yes ( ) No \ Walkout Bcisement ( ) Yes (side profile required) ( ) No CHARACTERISTICS OF PROPOSED NON-DWELLING Outside , Dimension Ft. x O O So. Ft.Setback to Lotlih^/ ^ Setback to Right of VK^^/X7//.£." "ti Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level 'XO ^ Ft. Setback to Septic Tank Ft. P\:fAA , Ft. X Ft."Ft. X a." So. Ft. \ Setback to LotliiW Setback to Right of^y Setback to Ordinary Hi^Wat^Level __ Elevation Above Ordinary^l^h Water Level Setback to Septic TanJ^ Setback to DrainfiM____ Setback to BiyF________ Maximum ^posed Height Atl*!. ^ Boathouse ^ * Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft.**Ft.**Ft.Ft.**Ft.** Ft.**Ft. Ft.Ft. Ft.Ft. Ft.Ft.Setback to Drainfield ^ & 0 Ft. ^ Setback to Bluff 3 SC? Ft. / a I*. v Maximum Proposed Height ZXG Ft. Roof Change ( ) Yes Ft. Ol Ft.Ft. Bathroom Proposed ( )Yes ( X)No " - ( ) Screen Porch ( ) Storage Structure TopoaraDhicaLAIteration / Earthmovinq □ None * Must include on scale drawing, additional Permit may be required.20 Cubic Yards or Less *□ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More’ pCtr-41'evV , fikff iaJ'II he. (pc-tx'l'ed. CHARACTERISTICS OF LOT: Lot ktea^^O Water Frontage /<? COfT Impervious Surface Ratio: I .Ft.) Yes ( ) No X100 .%Total Impervious Surface Onsite (FTO Total Lot Area (FTO Impervious Surface Ratio TH/S \S A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement; I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application, I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances.I understand that it is my responsibiiity to inform the Lan^jLA^urce Managemi Signature of Property Owner / Agent for Owner ' - offitt once the building footings have been constructed. /^/i/ :ov. 30/3Date: S~-^g-Zo 2.1 non Date:1^ Land & Resource Management fjcial PROJECT(S) TOTAL SQ.FT.,PERMIT FEE $RECEIPT NO. I Date Stamp ^ICAVIKEO Comments:KrCfciVEU 2013• i L&R InitialForm No. BK — 04-2013-05 351,158 • Victor Lundean Co., Printers ■ Fergus Falls, Minnesota CATION FOR ^ITE PERMITWHITE - Office APPLI f-9-n Cac ci^ GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us Tyni/-i9Permit No.APPLICATION MUST BE COMPLETED IN ORDER TO BE PROCESSED. LAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAME ;i43 y//3S PARCEL NUMBER (S) 0000^00f*/0&D S~iOOO^dCOC2001 >PROPERTY (E-911) ADDRESS »»/ 5/y^y' __________________J^ooo LEGAL DESCRIPTION Last Name First Initial Mailing Address Daytime Phone No. '39^' -T-T j 7>yo/r^4uq rtPkfer^onProperty Owner Pe-he.rSe>/\ Car/nr^e ^0-24C/t(.s4<e-^v Contractor Name Lie.#/ro ; - PROPOSED PROJECT (please circle the appropriate number)ONSITE WATER SUPPLY Individuai ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM(3) Replacement Dwelling* (6) Attached / Detached Garage (9) W.O.A.S. (1 ) New Dwelling ( 4 ) MH/YR (7) Add’n To Non-Dwelling (2 ) Add'n to Dwelling ( 5 ) RCU/Year_____ (8 ) Storage Structure ' ( ) Permit No. / '^i I ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 f ;(10) Non-Conf. Replacement (identify)"_______*•__________________^ (11) Other fidentifv) MAPAt .Xy'Pufi (12) Deck___________________ "Existing Non-Conf. Structure Verified by L&R•Removal of Existing Dwelling Verified by L&R lnspector‘s Initial/Date Inspector's Initial/Dale 1 CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. Setback to Lotliriq^___ Setback to Right ofVJ/ay Setback to Ordinary Hfgh Water Lpvel __ Elevation Above Ordinary High (Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff____ Total Bedrooms__/ Maximum Propos^Height____ Roof Change (/) Yes ( ) No Basement (/) Yes ( ) No Walkout Bdsement ( ) Yes (side profife required) ( ) No CHARACTERISTIC^OF PROPOSED NON-DWELLINGOutside , I ^ 1 ■ /I Ft.x SP Ft.)^^>’^^ > So. Ft.Setback to Lotlili^A^ W & — Setback to Right of /?7 / ^ fe." i Setback to Ordinary High Water Level Ft. Elevation Above Ordinary High Water Level *^0 —• Ft. Setback to Septic Tank Ft. Setback to Drainfield Setback to Bluff 3 Ft. Maximum Proposed Height “piO Ft. Roof Change ( )Yes Bathroom Proposed ( ) Yes ( x) / Outside DimensionDimensionFt.**Ft. X Ft. X ■r\\Sq. Ft. Setback to Lotlin'e^___ Setback to Right ofW^y Setback to Ordinary High,Water' Level __ Elevation Above Ordinary 1^1^ Water Level \Ft.&Ft."VFt."Ft.Ft.**4Ft.** Ft."Ft. Ft.Ft. Ft.Ft. Ft.Setback to Septic Tan Setback to Drainfi^ Setback to BIuIFI______ / Maximum Proposed Height fy) Bosmouse \ ) Gazebo ite Prior t4 Application / Inspection Ft.VftOFt. Ft.,Ft. 0'^ ( ) Screen Porch ( ) Storage Structurei-r- **Project/Lotlines/Right-of-ways Must be Staked Topoqraphif^al.Alteration / Earthmovina □ None Cubic Yards or Less * CHARACTERISTICS OF LOT: Lot Area ^$0 AcrP^~f^ * Must include on scale drawing, additional Permit may be required.I□ 300 Cubic Yards or More*□ 21 Cubic Yards - 299 Cubic Yards* uvf’ll be loca'^^. - 4-Water Frontage /P OOP **~Ft.) Yes ( ) No Impervious Surface Ratio:X100 .% Impervious Surface RatioTotal Impervious Surface Onsite (FT^)Total Lot Area (FT!) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances.I understand that it is my responsibiiity to inform the Land.& Re^urce Managem^t' office once the building footings have been constructed. Signature of Property Owner / Agent for Owner * Date:-1W 3kz- g-z.gi^ -Z( non A. Date:X Land & Resource Management Qfficial■J: PERMIT FEE $PROJECT(S) TOTAL SQ.FT.,RECEIPT NO. Comments: I-■i' t Form No. BK — 04-2013-05 351,158 • Victor Lundeen Co., Printers • Fergus Falts, Minnesota fi SITE PERMIT INSPECTION RESULTSI; Inspector must make all measurements and computations ~?oQ Ft.Ft.Structure Set Back from Ordinary High Water Level Ft.Ft.Structure Set Back from Top of Bluff Ft.Ft.Structure Set Back from Road Right of Way Ft.Ft.&Ft.Structure Set Back from Lot Lines Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank Ft.Structure Set Back from Drainfield Ft. Elevation Of Lowest Floor Above Ordinary High Water Level t Ft.Ft.ii j iiJ"Land Slope at Building Site %%4 Inspector’s Comments / Sketch: ! M -Vo I.J/ ,n 1?. i i ^4 «i() Inspector’s Signature 1 h I o Date of Inspection4o ^ Time of Inspection t^^roject Approved Date/initial / V I / ' ! -r STufl«T i Dbak^'iog T»flcfo PROM SaRwty bATpfi G7cT H,zooi_ »y reify Lee /\ntiei^sof^ N ■\ \ €lCv/{tioiO \ {I I\J \\ft(A\11\1 A\1 .AN\\\\t1 11\\\ \0)\ u ^IiA/£r )1I 1\ 1\wtu- ?oue )o\f I/\/r* J/^ /\ /» //A y// // // ? y7 / w //I I i ^ I 1 ^ !‘ :: Kijjs-o1 t® r^idrag£ SHtP\SfoR^t I SHti’\A\\ BC^JVKH^E 1\I ,-4\\ ■-V \✓fr \ lAVi>\\ \SSL^'^IAA ^ ^ t: .. .i:,, -ft'..-------;-..-:a-’>.Jif-‘.'-|. -■ i 't, <,-• . ' ifc ■ ,?"1: t •■ '/ -• V' V-*Ti It->5'^: ;r !■ / / / r"r_ 5ruft<»T 4 C<?^^lM^3£■ p^rrfl?5^(7A) *DrAii7'«)G TRflcfO p^t^OM Soni^v t>ftT££t G?CT M,2002_ Ky re^ayuse /{nbst^sofO \ •\x.N ■i\ \\r < <'■€iivBmoid\ \III J •■>■■'• 1\1I1\ 1\\1\\\I I\1}\w\it ■tI\I\f.\I !\ <®vj\■f \Z-1\a/£T 1 •t. -,v.<1 I'S 1%I\I \WtLU ;.0 li\ f■|£„ V fl> //(«tk■\ «\/«». /to; “ /f-r'm 1 •»-i 5// II/n 1 7/y A4/(1/<u// / ^/ /ft Ui f/ ^I %%. 'fi y <f k ; V: I 4\A ■/-,.f\SHOKS^S SH€P I3^6.T (f 4\ISfo«*^I :'»visg'\I 5C1.'''\ \A\"Bom \\4\>%\W>^\4!4r\\wtr «>»\'■& \Lfiuot>I \^P\Ir %■ \sy iV-.f?c A -------------0? i •> ■ .1»;!itv I .. f 'S4 :^iiSfMiis _____ ■•I..“i .-- „4. > y/y yV' y4:,•o y - N\\ o \ * ^I so"X..~ V o| podc\§ X I' r Bi.uf ^Vi V VI --^b STA*^ 4-A e: cr<rtf*+i0»\ I3zis “ WHITE - Office GOLDENROD - Inspector APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tail.mn.us YELLOW - Owner (after issue) PINK - Assessor Permit No.PLEASE PRINT OR TYPE ALL INFORMATION TWP NAMETWPNO.RANGELAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. '3 ?r /36 PARCEL NUMBER (S) QO 8.^000 O ?v—QOQ^ —OOO Vs^ ^J LEGAL DESCRIPTION PROPERTY (E-911) ADDRESS S'7-rce'f' - ’'A " Daytime Phone No.Mailing AddressFirst InitialLast Name ^ f' Qpn‘n/1«^PtieProperty Owner Contractor Name Lie.* PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add'n to Dwelling (5) RCU/Year______ (8) Storage Structure ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE; MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ( 3) 'Replacement Dwelling (6) Attached / Detached Garage (9) W.O.A.S. (I) New Dwelling (4 ) MH/YR Add'n To Non-Dwelling (10) Non-Conf. Replacement (identify) _ (II) Other (identify)______________ 'Existing Dwelling to be removed prior to. aj7__tj32M( ) Permit No. ( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuing Site Permit. Contact Rollie Mann at 218-864-5533 CHARACTERISTICS OF PROPOSED W.O.A.* , (WATEHsPRIENTED ACCESSORY STRUCTJffiE) .. Outside CHARACTERISTICS OF PROPOSED NON-DWELLING Outside . I Dimension lio Sq. Ft. 2 Setback to Lotline / Setback to Right of Way } Ft-** ^ Setback to Ordinary High Water Level ^(TO Ft. Elevation Above Ordinary High Water Level i S r 7 Ft. Setback to Septic Tank ?7 Ft. Setback to Drainfield Ft. Setback to Bluff //^ Ff. Maximum Proposed Height /l.'w Ji Ft. Roof Bathroom Proposed ( ) Yes {A) No CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) /Ft. X 7*/ ' Ft. Ft. X Ft."Outside Dimension___ Sq. Fl\ Setbacktofcqjline ___ Setback to RigtW^Way Setback to OrdinaryNiJigh Water L^el ___ Elevation Above Ordina^y,High ^ter Level Ft."Ft. XDimension to Lotline ___ Setback to Right of Way Setback to Ordinary High WateM^el __ Elevation Above Ordinary High>^er Level Setback to Septic Tank Setback to Drainfield / Setback to Bluff / Maximum Prop^d Height ( ) Boathoi^ ( ) Gazebfe **Project/Lotlines/Rlght-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft." Ft."Ft.&Ft.** 't."Ft. Ft.Ft. Ft.Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff______J_ Total Bedrooms / Maximum Proposed Might Roof Change ( ) les ( ) No ^ Basement ( )^s ( ) No Walkout Basen*ent ( ) Yes (side profiie required) ( ) No Ft. Ft.;t. Ft.Ft. Ft.Ft. Ft. ( ) Screen Porch ( ) Storage Structure ' Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina None □ 20 Cubic Yards or Less * □ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: Lot Area / M £"iSq. Ft. /v'LT xa' -’'-r_ xiSoT^^ Water Frontage (7 fTj/ / ^ — Ft.Bluff ‘'TSal Lot Area (FT^)Impervious Surface Ratio:.% Impervious Surface RatioTotal Impervious Surface Onsite (FTr) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibility to inform the Land & RgsQUlice Management o^ftC^OHce the building footings have been constructed. Signature of Property Owner / Agent for Owner^ Date: Date: m on B ** i.y c/// O rlt'lrf',' w\ H'^1PERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SQ.FT. 'tc>__On__ "Uj Y/LC /, .5/ O/yJ 1; jp4/p -r e- -th3 —hij- Oett- (A or^ ^ r/ O.j TComments: oS-ref.h u' ht 7il' '..r OiddJ./ tnr/A f>./ r> ' T/nenroi O^J'yST/L ■' LfQ.} A- J. Form No. BK -Tf 003-0407 £l_ 329,582 • Victor Lundeen Co.. Prirtters • Fergus Falls, Minnesota WHITE - Office GOLDENROD - Inspector APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 218-998-8095 www.co.otter-tall.mn.us YELLOW - Owner (after issue) PINK - Assessor EXPIRED Permit No.PLEASE PRINT OR TYPE ALL INFORMATION TWP NAMETWPNO.RANGELAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. .r /3 3Sr^A 4''O-D PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) ^ q ;r9.;= - -^oo' o oOQ ^ — OOP 3Pr^ r/nrrA LEGAL DESCRIPTION Daytime Phone No.Initial Mailing AddressFirstLast Name .9"/ < to ^ Cpr /.<?. s c 3JjApi/Property Owner T Contractor Name Lie.# PROPOSED PROJECT (please circle the appropriate number) (2) Add'n to Dwelling (5) RCUA'ear______ (jr ) Add’n To Non-Dwelling (8) Storage Structure (10) Non-Conf. Replacement (identify)___________ (11) Other (identify)_________________________ •Existing Dwelling to be removed prior to__________ ONSITE WATER SUPPLY t'4 Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM(3) 'Replacement Dwelling (6) Attached / Detached Garage (9) W.O.A.S. (1 ) New Dwelling (4 ) MH/YR_____ijsM( ) Permit No. ( ) OTWMD ‘Must have Sewage System Approval from OTWMD prior to issuing Site Permit Contact Rollie Mann at 218-864-5533 CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELLING Outside .,Dimension lap 3 9V CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension___ Sq. Ft. Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Draintield _ Setback to Bluff_____ Total Bedrooms_____ Maximum Proposed Height_____ Roof Change ( ) Yes ( ) No Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No I 2*/* Ft.Outside DimensionFt. XFt.**Ft. X Ft.**Ft. X///Sq. Ft.(SqFt Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Lewi __ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Drainfield Setback to Bluff__/ PTFt.**Ft.&Setback to Lotline Setback to Right of Way ) Ft.** Setback to Ordinary High Water Level .A OD Elevation Above Ordinary High Water Level I St 7 Ft.& /Ft.** : Ft.**/3-Ft.**Ft.' OFt.Ft.Ft. Ft.Ft.Ft. Setback to Septic Tank 'i /' Setback to Drainfield '3 Ft. Setback to Bluff 4 '*1 Maximum Proposed Height l3i Ft. Roof Change ( )Yes (• ■ ) NV ' : J )io Bathroom Proposed ( ) Yes ( ' ) No Ft.. V Ft. Ft.Ft.yFt.Ft.Ft. I Ft.Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ( ) Screen Porch ( ) Storage Structure * Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina □ None □ 20 Cubic Yards or Less * □ 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More* CHARACTERISTICS OF LOT: CVS V , Water Frontage ^ •" Ft. Total Lot Area (FTO Bluff ( )YesSq. Ft.Lot Area. X100 =.%Impervious Surface Ratio:T Impervious Surface RatioTotai impen/ious Surface Onsite (FT!) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express con dition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & ilesoui^e Management^ffiep once the buiiding footings have been constructed, n., F-Sr-O'/3 ________________ Signature of Property Owner / Agent for Ownef/1(/- ])Date: Land & Resource M^nag^ept OfficePERMIT FEE $ /-O CT 3 /RECEIPT NO.PROJECT(S) TOTAL SQ. FT..t Q4>\a one^-STcYh3hi i f jComments:Uiout j't -H?/y}4i ! r / /P»/ ■ J'rA 7 • Fergus Fails,Form No. BK — 1003-0407 329,5B2 • Victor Lundeen Co., Prirtlers SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations ^ cX)Ft.Ft.Structure Set Back from Ordinary High Water Levei fOPr Ft.Ft.Structure Set Back from Top of Bluff I ^Ft.Ft.Structure Set Back from Road Right of Way Ft.&i /5 OQ Ft.Ft.&Structure Set Back from Lot Lines /\H Ft.Ft.Structure Height loo'Ft.Ft.Structure Set Back from Septic Tank /Ft./Od Ft.Structure Set Back from Drainfield Elevation Of Lowest Floor Above Ordinary High Water Level____________________Ft.Ft. Land Slope at Building Site %% - CLtctInspector’s Comments / Sketch: I r" 11 <A Inspector's Signature 4^%Olb Date of Inspection 9 - io plrv^ Time of Inspection S^roject Approved e/Initial ^Dat FxH/^fT ^ Stuart S. and Corinne D. Peterson Property Description Star Lake Township, Otter Tail County, Minnesota Government Lot Two (2) of Section Two (2), and Government Lots Five (5), Six (6), Seven (7) and Eight (8) and the Northwest Quarter of the Southeast Quarter (NWi/4 SEi/4) of Section Three (3), Township One Hundred Thirty-five (135) North, Range Forty-one (41) West, except easements, restrictions, reservations of mineral rights of record, if any, and except the following tract: Exception: That part of Government Lot Five (5) of Section Three (3), Township One Hundred Thirty-five (135) North, Range Forty-one (41) West, Otter Tail County, Minnesota, described as follows: Commencing at the center of said Section Three (3); thence North 00"40’28” West (assumed bearing) along the West line of said Government Lot Five (5) a distance of 33.05 feet to the point of beginning; thence South 87“35’27” East a distance of 35.90 feet, thence North 09°10’37”East a distance 757.89 feet; thence North 79‘’11’28” East a distance of 284.98 feet, thence NorthlO"35’23” West a distance of 302.00 feet more or less to the shore line of Star Lake, thence westerly and northwesterly along said shore line a distance of 445.00 feet more or less to its intersection with the West line of Government Lot Five (5) of said Section Three (3); thence South 00“40’28”East along said West line a distance of 1218.00 feet more or less to the point of beginning. Containing 5 .13 acres more or less. 5 SCALE DRAWING FORM I Tax Parcel Number(s) The scale drawing must include the outside dimension (lotlines) of the property above the ordinary high water level, and must identify the type, size (square feet), and location of all existing and proposed structures, additional onsite impervious surfaces, road right-of-way(s), ordinary high water level(s), septic tank(s), drainfield(s), bluff(s) & wetland(s). Must also include all proposed topographical alterations. zr \ ij ■ I Signature of Property Owner Date BK — 0207 329X386 • Victor Lund«en Co., Printers • PerQue Fails, MN • 1-805-346-4870 IMPERVIOUS SURFACE CALCULATION WORKSHEET: List of Onsite {Existing and Proposed) Impervious Surfaces (must be shown on scale drawing): Structure(s): Deck(s): Driveway(s): Patio(s): Sidewalk(s): Stairway(s): Retaining Wall(s): Landscaping: (Plastic Barrier) Other: TOTAL IMPERVIOUS SURFACE: Ft2LOT AREA: .%X100 == IMPERVIOUS SURFACE RATIOLOT AREATOTAL IMPERVIOUS SURFACE APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) 121 W. JUNIUS AVE. SUITE 130, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.us WHITE - Office odiDENROD - Inspector YELLO\^ - Owner (after issue) PINK - Assessor ■2-0Permit No.PLEASE PRINT OR TYPE ALL INFORMATION RANGE TWPNAMETWP NO.LAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. S'r/Q/^ ^0003 3 OOOy -ooo-^:o ^->oP -ooo ^ PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) legaltJescrip Daytime Phone No.Initial Mailing AddressFirstLast Name .C~fMQr"f S ,cs/cv^-s/^131/ C4.C-fPry^J//}A^^S/iP:^ 96-^^ rrf.^ />V? Z' M A/ 9 PetcrSayyProperty Owner ity^Pti-fer-Sori Pr->nnnp. p.s/f S'. jT\jy'J-'cJ’y 90Contractor Name :> 'J ONSITE WATER SUPPLY i/j ONSITE SEWAGE ^Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) ^^'Replacement Dwelling (6) Detached Garage (9) W.O.A.S. TREATMENT SYSTEM , ^ ^ ,kimdAM(2 ) Add'n to Dwelling ( 5) RCUA'ear_____ ( 8) Storage Structure _ 'Existing Dwelling to be removed before /'/—< ■- (1 ) New Dwelling (4 ) MH/YR (7 ) Add’n To Non-Dwelling (10) Other (>5 Permit No. ( ) OTLSD * This permit is only valid alter verihcatkin from the O.T.L.S.D. that a conlormirtg sewage system wiil be mstalled to service this iot contact Rollie Mann at 864-5533. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)CHARACTERISTICS OF PROPOSED NON-DWELLING OutsNte Dimen^n CHARACTERISTICS OF PROPOSED DWELLING VOutside Dimension So Ft,"U^SP Ft.x Outside DimensiiFt. X Ft.",Ft.;;Ft. X SeibaSl^trtOTin fT/r<KiTAisf'f reni Sq. Ft. \ Setback to Lowte Setback to Right of Way Ftl^ ^ ____ Setback to Ordinary High Water Level 7-J ~r ¥tr _ , , _ , X., /<~fj a/ Setback to Ordinary HigrvWater Elevation Above Ordinary FflgW Setback to Septic Tank / Setback to Drainfield / Sq. Ft. \ Setback to Lotlinh___ Setback to Right onWay Setback to Ordinary Hw Wate^evel __ Elevation Above Ordinary\i^ Water Level Setback to Septic Tank / Setback to Drainfield / Setback to Bluff / Maximum Propo^d Height ( ) Boathouse ^/'^^^^'^^^je^fC^ines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection /6t Ft.&Ft.&Ft."Ft."Ft.& Ft."Ft.” Ft.lel Ft.Elevation Above Ordinary High Water Level _ Setback to Septic Tank Ft. Setback to Drainfield SO Ft, Setback to Bluff Ft. Maximum Proposed Height Basement ^ Yes later Level Ft. Ft.Ft. Ft.Ft.Setback to Bluff / Maximum Propo^ Height Bathroom Prooosed ( ) Yes ( ) No Ft.Ft.No i/ No^Ft.Walkout Basement Total Bedrooms SL ( ) Screen Porch \ ( ) Storage Structu Topographical Alteration / Earthmovinq ^OO ^ 5 \ ^o □ None □ 20 Cubic Yards or Less* □ 21 Cubic Yards - 299 Cubic Yards' □ 3(l0 Cubic Yards or More* tTqTSS CaVOV-it'cA AS t Ft. * Must include on scale drawing Permit may be requiredv~v<Lw [xvT^ ^ A/^T ^• CHARACTERISTICS OF LOT: ^ /90 S &a. Ft.Water FrontageLot Area.old Co YvVo i l(t n Impervious Surface Ratio:,%\ ~TG Impervious Surface RatioOij^e ^r^)1 Total Lot AreI ^Total Impervi sfv rbTHIS IS A SITE PERMIT ONLY AND DOES NOT CONSTTTUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibility to inform the Land & Resource M iment office once the building footings have been constructed. Signature of Property Owner Ccri.L/A? - y- o3 lo - \A-^cd Date: Date: _____ -r Srww// Ayp pY'Land & Resource Management OfficeISOPERMIT FEE $RECEIPT NO.PROJECT(S) TOTAL SQ. Comments: Conc//^f a f SC- -^(7^ '/Aid o/?c/'S^ueJ /P'- ^ Form No. BK — 0203-0501 313,012 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT, OTTER TAIL COUNTY (218-998-8095) 121 W, JUNIUS AVE. SUITE 130, FERGUS FALLS, MN 56537 www.co.otter-tail.mn.us VlfHITE - Office GOLDENROP - Inspector >^LLOW - Owner (after issue) PINK - Assessor pjdEiidJi/i ~h Io/nIo^No.PLEASE PRINT OR TYPE ALL INFORMATION RANGE TWPNAMESECTIONTWP NO.LAKE/RIVER CLASSLAKE / RIVER NO.LAKE/RIVER NAME V/&D ^/3s- -ooo -0009 - ooo ^ /V-T ^jQ /__________ LEGAL description ' . ~ . •> /t/w ^ 7^ . f 7k ^ f 7 Aj f ^ ^ PROPERTY (E-911) ADDRESSPARCEL NUMBER Daytime Phone No.Mailing AddressFirst InitialLast Name CT.,^,+ S CS/W s/a!>Pe.ferSon \3lt Qir.QfP^J//)A^CS/£/f?Property Owner iX s/9 7^8-379^Pg'f'erSpn Cnnnnp. p. /^j^.tS^.fjL A/Hi/'^P~~i’AA/s'7^;■SV3:^Sr5 90Contractor Name Lie.# I/ f 74/ ONSITE WATER SUPPLY i/ JxJ Individual ( ) Public ( ) None NOTE: MN Ruies Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) ^ ^f^’Replacement Dwelling (6 ) Detached Garage (9) W.O.A.S. ONSITE SEWAGE TREATMENT SYSTEM , ^ ,{2 ) Add’n to Dwelling ( 5 ) RCUYear_____ (8) Storage Structure _ 'Existing Dwelling to be removed before//- I ~ 03 (1 ) New Dwelling {4 ) MH/YR (7) Add'n To Non-Dwelling (10) Other (>i Permit No. ^ ( ) OTLSD * This permit is ortly valid alter verification from the O.T.L.S.D. that a conforming sewage system wiit be installed to service this lot contact Rollie Mann at 864-5533. CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimensida, CHARACTERISTICS OF PROPOSED NON-DWELLING Outside DimenSk^n^_^ CHARACTERISTICS OF PROPOSED DWELLING Outside Dimension S & Ft. x 30 Ft.**t/Ft. X Ft.** Sq.pL ‘apr/py S/w,r/Uf/ ant! bacifitrtbtline /01~ Ft. & /O'^ Ft.lj/ Setback to Right of Way /a Mile Fl>^ Sq. Ft. Setback to Lotlihe^____ Setback to Right of Way , Setback to Ordinary Elevation Above Ordinary Setback to Septic Tank _ Setback to Drainfield / Setback to Bluff / Maximum Proposed Height /Bathroom Proposed ( ) Yes ( ) No Sq.Ft.____ Setback to Lotlins ___ Setback to Right orV^ay Setback to Ordinary WatetLevel Ft. Elevation Above Ordinary T(igh Water Level Setback to Septic Tank Setback to Drainfield ^ Setback to Bluff Maximum Proposed Height ( ) Boathou^^ Ailj/!lI ' () Gazebo / 4^Z^'^*Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Set Ft."Ft.& Ft."7S-I- Ft.i-^Setback to Ordinary High Water Level _Elevation Above Ordinary High Water Level /Sw 7 PK^ Setback to Septic Tank Ft. Setback to Drainfield SO Ft. Setback to Bluff A'Ft. Maximum Proposed Height Basement *>4 Yes Walkout Basement ^ Yes Total Bedrooms Water Lwel Ft. \ ater Level Ft. Ft.Ft. Ft.,2_S_Ft.<^- _______No j/ Ft.Ft. NoZ^Ft. ( ) Screen Porch ) Storage Structut^( Topographical Alteration / Earthmovina 4% V ^ \ j —> □ None □ 20 Cubic Yards or Less *. □ 21 Cubic Yards • 299 Cubic Yards*_________ /* S "t Ft. * Must include on scale drawing Permit may be requiredV-v<L VJ (3vVT^ A/ar “ vpZj 9 6 □ 3(J0 Cubic Yards or More* Ca V c;v> tr- c5r/V r'CHARACTERISTICS OF LOT: Lot Area /‘Tl-' /t ’ j-. So. Ft.fWater Frontage old b>v- \ \ i \( r-* Impervious Surface Ratio:X100 .% ^ Total Lot Area (^r) ^-V-Qv> r V Impervious Surface RatioTotal Impervious Surface OnsiteJFT*) ms IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform\the Land & Resource Management office once the buiiding footings have been constructed..-/J / .y /n//O - 7- sDate:} W lature of Property Owner ) o—\ V -.lll\# PERMIT FEES Date: & Resource Management Office. I,.f- t • 4 r' f I T3 ■ ^RECEIPT NO.PROJECT(S) TOTAL SQ. FT.. Comments: / //re ^9^3 Y o^e/KSS//fcfP>e /' /7 Form No. BK — 0203-0501 313,012 • Victor Lundeen Co., Printers • Fergus Falls, Minnesota V m K SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations ir-iTo'Structure Set Back from Ordinary High Water Level Ft.Ft. Structure Set Back from Top of Bluff Ft.Ft. Structure Set Back from Road Right of Way Ft.[(JCSCJ Ft. Structure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. IStructure Height Ft. Ft. Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %% rc/ \ ^ ^c(KInspector’s Comments / Sketch: iC ?0 LL ?. 1 _• •«. I Inspector's Signature Date of Inspection Time of Inspection 't. qU \''Q Project Approved \Date/Initial // 1> rauftnj 'i'r^cej f'r'am 1 E>«.tet/ Oc+ IH,1oO£. / // //" = ^ Denotes £lwA»f*»n / /St<»r»<}‘ Sirxji / f //S+or«^6 SWi / orftft. LAK£ V fa- /3* 3 Vs, ^ I i o\A- 'W ^ U> cL ^<J L \ V \ ~h ^ ^ GRADE & FILL APPLICATION OTTER TAIL COUNTY LAND & RESOURCE MANAGEMENT 121 W JUNIUS SUITE 130, FERGUS FALLS, MN 56537 Otter Tail County’s Webside: www.co.otter-tail.mn.us 218-998-8095 PERMIT NO._____ Application Fee_______ Receipt Number_______ SfUAAr S. ^ D. Pztzrs^a/PROPERTY OWNER MAILING ADDRESS I3il Sf. Sf Pe»4(/v)a;CITY, STATE, ZIP DAYTIME PHONE NUMBER LAKE NAME PARCEL NUMBER tS) £6 ' PQO • ol- -i>00 SECTION2 tS TWP )3^ RANGE V/ LEGAL DESCRIPTION __________________ Lxft Z ri, ^ riar 1 t LAKE NO. S6 CLASS ^7^ TWP NAME lOt/jf E-911 PROPERTY ADDRESS 2/4f9¥ 39T‘^S^.______S^^29 Received L&R Official DATE PROJECT REQUEST (PROVIDE THE scale drawing on BACK) So 29ooSB FT*CUT AREA:FT. X FT. = FT*FILL AREA;FT. X FT. = MAXI^WWr DEPTH OF CUT:(r1>0ytmUM S*}FT. MAXIMUM DEPTH OF FILL: 3TOTAL CUBIC YARDS OF EARTHMOVING REQUESTED: %3L00 DESCRIBE YOUR PROJECT BELOW Estimated Cubic Yards to Be Removed: 400+/- Cubic Yards.- We are digging a walk out basement on a site where an existing smaller cabin (also with a walk out basement) formerly stood. Because of the existing basement area and natural slope of the ground, a relatively modest amount of dirt work will be required. Much of , the site to the north and east is already at “grade” and will require no excavation. I : estimate the average depth of cut to be less than 4’. Excavated gravel will temporarily f be piled on site to be used as back fill and leveling where the two existing buildings t formerly stood. Because of the slope of site, gravel temporarily piled can not wash to the lake. Any uimeeded excavated gravel will be moved to a paved surface and used in the future on our extensive driveway.^^2;^ Xktt Id ^ ______________ JO '^'0 3 SIGNATURE OF PROPERTY OWNER/AGENT FOR OWNER±A DATE BK04/03 313,680 * Vlckir Lundfl«n Co.. Printon ■ Fergu. FbIs, MN * 1.800.346.4870 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHiTE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor Permit No.PLEASE PRINT OR TYPE ALL INFORMATION TWP NAMETWP NO.RANGELAKE/RIVER CLASS SECTIONLAKE/RIVER NAMELAKE / RIVER NO. St fife3^I3SGS> PROPERTY (E-911) ADDRESSPARCEL NUMBER (S)SC <^o<^ 2. OOC^ ^Sa 300/3 00S ^39s~^ SA ^ S£^ S jL<sf~C> LEGAL DESCRIPTION ^ Cja^j^r ty'uyr^, Daytime Phone No.Initial Mailing AddressFirstLast Name )^i€r'Son , 3^uciC^ S )3/i _________ 3f n)AP ^r/-C,Yt/~'5/oOProperty Owner ?S'V- 279/P’.g'V 'erStry\ r,-? r *r> K>.-P i£Contractor Name Lie.# i-e. ONSITE SEWAGE ^ TREATMENT SYSTEM ONSITE WATER SUPPLY ^^^ndividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add’n to Dwelling ( 5 ) RCU/Year_____ (7 ) Add’n To Non-Dwelling ( 8 ) Storage Structure (10) Other, ( 3 ) 'Replacement Dwelling (f^Detached Garage (9) W.O.A.S. (1 ) New Dwelling (4) MH/YR____( ) Permit No. ( ) OTLSD * This permit is only valid alter verifcalion Iron) the O.TLS.D. that a conforming sewage system will be installed to service this lot contact Rottie Mann at 864-5533.'Existing Dwelling to be removed before. CHARACTERISTICS ^PROMSE^ON-DWELLING Outside ' Dimension Setback to Lotline \O0 Ft. & -<• I £>C? FVOt: Setback to Right of Way 4* if)0 Setback to Ordinary High Water Level JSOO Ft.^/t Elevation Above Ordinary High Water Level I O * Ft. Setback to Septic Tank •F SC? FLQfc^ Setback to Drainfield SO Ft.^/C Setback to Bluff SO Ft. O Maximum Proposed Height /' fr-2oFt. GK Bathroom Proposed ( ) Yes J^) No ^fC AmMidJwL CHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)Outside Dimension Ft."Ft. XFt. X Ft."Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff ____ Ft."Ft.&Setback to Lotline___ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Ft."Ft. X Ft."Ft."Ft.& Ft.Ft."Ft.Ft.Setback to Septic Tank__ Setback to Drainfield __ Setback to Bluff_______ Maximum Proposed Height Basement_____ Walkout Basement Total Bedrooms_ Ft.OK Ft.Ft. Ft.Ft. Ft.Ft. Yes No Ft. NoYes Ft.Maximum Proposed Height ( ) Boathouse ( ) Screen Porch ( ) Storage Structure( ) Gazebo "Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection ' Must include on scale drawing Permit may be required Topoqraphicai Alteration / Earthmovinq □ None 9pc tmrds - 299 Cubic Yards'□ 300 Cubic Yards or More'□ 20 Cubic Yards or Less '21 Cubic CHARACTERISTICS OF LOT: Lot Area_4i26—k^YesWater Frontage 4~Bluff NoFt. — //)Impervious Surface Ratio:.%X100 = Imperious Surface RatioTotal Lot Area (FT')Total Impervious Surface Onsite (FT^) ms IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances.(e opce thejbuilding footings have been constructed.I understand that it is my responsibility to inform the Land & ^eeoorCMVI^ hhili-i. gem Signature of Property Owner Date: ?//z/O -2.Date: Land & Resource Management Office cJk.RECEIPT NO.PERMIT FEE $ / Comments:a__trU9eJUU. A.k 306,636 • Victor Lundean Co., Printers • Fergus Falls, MinnesotaForm No. BK — 0500-0501 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW - Owner (after issue) - PINK - Assessor .4a l9y9o i1Permit No.£PLEASE PRINT OR TYPE ALL INFORMATION 3 ^ LAKE / RIVER NO.TWPNAMETWPNO.RANGESECTIONLAKE/RIVER CLASSLAKE/RIVER NAME i )3S'GP 1PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) ZOO/Jooo 'i3‘Y9‘/ 39T- S/. , V ' ^^4-■i 2- Lti>i ^ S-^CL- 3 Zd> f G LEGAL DESCRIPTION ■1 Daytime Phone No.Mailing AddressFirst InitialLast Name P^fer5©o y ^f’uaC^ S \3ll Of._______ /y)A/ ^S/09 ^s7~CYu-y/ooProperty Owner 7^ 7i/90S''^- ^7%,F{ '€rSCfy\ Cn n*r> Cp j-fContractor Name Lie.# ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY Individual { ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. PROPOSED PROJECT (please circle the appropriate number) ( 2 ) Add’n to Dwelling ( 5) RCU/Year______ ( 8 ) Storage Structure _ "Existing Dwelling to be removed before. >)(3) 'Replacement Dwelling (I^Detached Garage (9) W.O.A.S. (1 ) New Dwelling (4) MH/YR (7) Add'n To Non-Dwelling (10) Other ( ) Permit No. ( ) OTLSD * This permit is ortly valid after verrScahon from the O.T.LS.D. that a rxmforming sewage system wilt be installed to service this lot contact Flotlie Mann at 864-5533. DWELLINGCHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE)Outside __ , DimensidlT j ls. Ft. x r-a' Setback to Lotline \O0 Ft. & I <»C> FV'OK Setback to Right of Way (OO FV'OK Setback to Ordinary High Water Level ^OQ Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank F SD* Ft.<5|^ Setback to Drainfield F(^K Setback to Bluff ^SO Ft.£)K Maximum Proposed Height / fr»2oFt. Oi^ Outside Dimension Setback to Lotline ____ Setback to Right of Way Setback to Ordinary High Water Level ___ Elevation Above Ordinary High Water Level Setback to Septic Tank___ Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height Basement______ Walkout Basement Total Bedrooms__ Ft." *■> Ft. X Ft.”Outside Dimension Setback to Lotline ____ Setback to Right of Way Setback to Ordinary High Water Level __ Elevation Above Ordinary High Water Level Setback to Septic Tank Setback to Drainfield _ Setback to Bluff_____ Ft."Ft.&Ft."Ft. X Ft.”Ft."Ft.& Ft.Ft." Ft.I ft-~DK Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. NoYes FI. Yes No Bathroom Proposed ( ) Yes p^) No ^ j< 3tnomed Ft.Maximum Proposed Height ( ) Boathouse ( ) Screen Porch ( ) Storage Structure( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Application / Inspection * Must include on scale drawing Permit may be required Topographical Alteration / Earthmovlng □ None □ 20 Cubic Yards or Less * 9o 21 Cubic Yards - 299 Cubic Yards*□ 300 Cubic Yards or More' CHARACTERISTICS OF LOT: Bluff YesWater Frontage *~f~No.Ft.Sq.ft,Lot Area. .%Impervious Surface Ratio:X 100 =Impenriaus Surface RatioTotal Lot Area (FT^)Total Impervious Surface Onsite (FTr) THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and according to the provisions of the Ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon express condition that the person to whom it is granted, and his agent, employees and workmen shall conform in all respects to the Ordinances of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said Ordinances. I understand that it is my responsibiiity to inform the Land & Resource K^agen^ent o^ce once the buiiding footings have been constructed. Date: ^ ______________ _____... .ZZZu. ^ ^ Signature of Property Owner Date: Land & Resource Management Office cJr. 3Z)ZRECEIPT NO.PERMIT FEE $ f AYc) / $ rwA---} t {Comments: jLL./.I S OL- Id h.s. 308.638 • Victor Lundeen Co., Printers • Fergus Falls. MinnesotaForm No. BK — 0500-0501 SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations m 7 IFt.Structure Set Back from Ordinary High Water Level Ft. Ft.Ft.Structure Set Back from Top of Bluff ZO'h Ft.Ft.Structure Set Back from Road Right of Way Ft. & Ft.Ft.Ft.&Structure Set Back from Lot Lines i f Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Drainfield Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %0 - 5^% Inspector’s Comments / Sketch: Inspector’s Signaturt Date of Inspection Time of Inspection ' Date/Initial ^^^CQiect Approvi !■ H- > mt Ghjm Julu >d^Auirt.^ ■— _ G^mu^ uc -Scstzm '. f/s/fiA! (Vi^ // / .A' ^ \ ioutm.!^ liL'T-.v-. \ \ P>tvf^y (? 1C £■><■! 'S', ^t-ji, /M V2*(~>X k f Cort/ihc ^ipr^n Go*rHoif2,S9cf,o^2 onj $ovf Lcrfs KCiZg (mJ ffec-fionB, T /35, I /8</ Ac^^« 1 1 ^i♦i/f^y JL -1^ TtJoVG^ StuSTttJ^ 2MXI*i -h o cv lb t^ke & (DOCK BUILDINQ) ACK HOI'S ; f • V i APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE — Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor LEGAL Permit No. DESCRIPTION IM 3-AND IbnsLOCATION LAKE NUMBER LAKE/RIVER NAME SECTIONLAKE/RIVER CLASS ^ _ gQ ^ TWP NO.RANGE TWP NAME /3rb PARCE(. NUMBER (S) ^FIRE OR LAKE ASSOCIATION NUMBER 3 S<- GO IDENTIFICATION: Please Print All Information ^—^First Mailing Address — No. Street, City and StateLa5Initial Zip Code Telephone No.ame I ^ II Ke^-fcon sH- s-h fojjj. bsim t'httson, yfyo-'^Property Owner rNameContractor State Lie. ft PROPOSED PROJECT PROPOSED USE RESIDENTIAL USE NON-RESIDENTIAL USE ( ) Garage Utility Structure ) Water Orientated Accessory Structure CHARACTERISTICS OF PROPOSED ( 1^)/New Structure j io ( ) Orttst^amily Dwelling ( ) Multipfe^Qwelling # of Units (^\. ) () Residential Non-Residential Basement P) p ) ) Addition ( ) MH/RV Walkout Basement ( Outside Dimension"2, (r>'J'C\l of Structure______2_±_Z_U_/_Ft. 1^TYPE OF FRAME ONSITE SEWAGE DISPOSAL SYSTEM ONSITE WATER SUPPLY ( ) Other Height of Structure. # Of Stories_____ Ft. ;() Ma^ry L-^rC^od ( ) Public OFFICE USE ONLY ( X/J^Bluff Impact Zone>^ ( Shore Impact Zone Sensitive Area ( ) Public ■a((# Of Bedroomsidividual Ui/7Individual Permit #_ ( ) OTLSD (( ) Structural Steel ( ) Other ) None # Of Bathrooms ( LOT SIZE AND SETBACKS:1000 ^Lot Area is square feet. Water frontage is feet. Maximum depthyOf lot feet. Building set back from ordinary high water level is feet. (String Test) Land height above ordinary high water level at building line is Slope of lolfeet.% I ( l-l- 15 C'-Uo-f'-f y~j-y\yciu/t U^i/l 3o'-h Hsl. feet from soil absorption system (Sewage System Permit must be obtained before installation). -f _ —THIS fS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES. . I Agreement: l hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and accord ing to the provisions of the Ordinances of Otter Tail County. Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months (I understand that it is my responsibility to inform the Land £r Resource Management office Building set back from road right-of-way.feet. TO inLot line setback is and feet. toStructure will be located feet from septic tank (Sewage System Permit must be obtained before installation). Structure will be located le building footings have been constructed.)ice Dated: Signature of Owner I f Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agent, employees and workmen shall conforry in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. Dated: Land & Resource Management OfficetiWiiPermit Fee $.Receipt No. Comments: ^ f)K , ) Form No. BK — 0292-002 270.500 • Victor Lundeen Co Printers • Fergus Falls. MN • 1-800-346-4870 V -»!'■'r APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 WHITE — Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor LEGAL Permit No. DESCRIPTION Lof 3- QyiAND Ib'l5LOCATION iLAKE NUMBER LAKE/RIVER NAME SECTIONLAKE/RIVER TWP NO.TWP NAMERANGE ihs a I PARCeI- NUMBER (S) J FIRE OR LAKE ASSOCIATION NUMBER CUD 3 io IDENTIFICATION: Please Print All Information Last Name_____________ 4^ First Initial Mailing Address — No. Street, City and State Zip Code Telephone No. II 3-FV/?cProperty Owner T^vV ^5 fC?S4tj tT NameContractor State Lie. # PROPOSED PROJECT PROPOSED USE RESIDENTIAL USE NON-RESIDENTIAL USE ( ) Garage Utility Structure CHARACTERISTICS OF PROPOSED ■^,‘tNew Structure ( ) Addition. ( ) MH/RV - ) OnevFamily Dwelling ) MultipleS^elling # of Units (^\ ) () Residential Non-Residential (Basement ( Walkout Basement ( Outside Dimension of Structure______ (h''"'() Water Orientated Accessory Structure Ft.YEAR TYPE OF FRAME ( ) Masonry ( •—jTWood ( ) Structural Steel ( ) Other ONSITE SEWAGE DISPOSAL SYSTEM ONSITE WATER SUPPLY ( ) Public (_..-)dndividual ( ) None { ) Other Height of Structure, # Of Stories______ Ft. / OFFICE USE ONLY ( V^Bluff Impact Zones ( /Ml Shore Impact Zone ' M Sensitive Area f( ) Public ( '—5^Individual Permit If_________ ( ) OTLSD -0# Of Bedrooms # Of Bathrooms ( LOT SIZE AND SETBACKS:1.000 +Lot Area Is square feet. Water frontage is feet. Maximum depthyof lot feet. -15Building set back from ordinary high water level is feet. (String Test) Land height above ordinary high water level at building line is j feet. Slope of lol % <^0 C /-T i4 15 .feet from septic tank (Sewage System Permit must be obtained before installation). f 1 k/ / feet from soil absorption system (Sewage System Permit must be obtained before installation). J ^ 'Ac— Building set back from road right-of-way.feet. TO LQLot line setback is and feet. lOStructure will be located Structure will be located THIS ISA SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES. Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with the description above set forth and accord ing to the provisions of the Ordinances of Otter Tail County. Minnesota. I further agree that any plans and specifications submitted herewith shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months (I understand that it is my responsibility to inform the Land B Resource Managementjjf^e^nce~Yl^e building footings have been constructed.) Signature of Owrmr I ' Permit: Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the express , condition that the person to whom it is granted, and his agent, employees and workmen shall confornfl in all respects to the Ordinance of Otter Tail County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. ft ( (Dated: Dated: 50'+Land S Resource Management Office Permit Fee $.Receipt No„ Comments:-I nA oK 7 Form No. BK — 0292-002 270.500 • Victor Lundeen Co Primers • Fergus Fills. MN • 1'800‘346-4670 INSPECTION RESULTS Make all measurements and computations ACTUAL MINIMUM Sq. Ft. Building Set Back from High Water Level Ft.Ft. Building Set Back from Top of Bluff Ft.30 Ft. ■P/rrOoBuilding Set Back from Road Right of Way Ft.20 Ft. ■tfOtf Ft. & +^‘^0 FtBuilding Set Back from Lot Lines Ft. Building Height Ft.Ft. Building Set Back from Septic Tank Ft.10 Ft Building Set Back from Absorption System Ft.20 Ft Elevation Above High Water Level at Building Line ■4^ 5 Ft.3 Ft. p -ZoLand Slope at Building Line % ; 3(/yC Sip 5>ist,jcLInspector's Comments/Sketch:^ X i i i \Inspector's Signature !h 7-^yIDate of Inspection Time of Inspection i..*- ji.^ * L ■ ’/ ■ /I ■x>i :h;i (COMANCHE) (CHOCTAW) !/\J I PiZ£>Clt<.^ OP (READ)^ /(CHEROKEE) ) (OJIBWAY) f(RECREATION HALL) ■V ■’ t t I (SHOWER UPPE'r r I t^PUMP HOUSE) I t I f//.//// (SAOJ3A)'.ri(B-TBER "■'’OP) I 4,P (DOCK BUILDING)fJlP w pi(SIOUX) 'ACK HOlFM i I /// Star lake(LOWER WAS ROOM)i CAMP AQUILAI !Stuart S. PetersonSection 3, Township 135 North, Range 41/ West SCALE (SH (LOWER PUMP HOUSE) | | (INFIRMARY)(MAIN LODGE) ,/ / // ; ! h .