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Home My WebLink AboutSwan Lake Club_13000190112000 _ 18364_Shoreland Permits_White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT ■na IO^Q La (<Le C> J u Permit No„LEGAL DESCRIPTION AND LOCATION m5^^^-78/ (5ooat^/I JSc^ Aao I irTg TWP NameTWPRangeLake Classif.Sec.Lake No.Lake Name IDENTIFICATION: Please Print All Information Zip No.Tel. No.Mailing Address— No. Street, City and StateInitialLast Name First IZo /I.SCOwner■7^I IAdr>g CofB.NameContractor Architect Name. NON-RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE: l^il^ew Building | 0 |-|0^-L^ One Family Dwelling ( ) Multiple Dwelling ( ) Other f Specify:. ( ) Alteration Units ( ) Other Size ESTIMATED COST OF IMPROVEMENT $ TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:DIMENSIONS: (xSCno( ) Masonry Wood Frame ( ) Structural Steel ( ) Other — Specify Vl&fi( ) Public ^P'^Jjidividual Septic Tank, etc. WATER SUPPLY: Basement: ( ) Yes Stories above basement:iM. Sq. feet (outside dimension) Bedrooms -1-...( ) Public Individual Well Baths ■fo"/ o| d Type of Roof: 31CHARACTERISTICS: feet.Maximum depth of lotWater frontage is feet.Lot Area is square feet.18(2Building set back from high water mark is........ Land height above high water mark at building line is Building set back from State highway right of way.... Side yard is Structure will be located feet. (Building Line) 3 feet 2.050feet — from road right of way is feet. 1..Q and feet. IQ....feet from septic tank (Sewage System Permit must be obtained before installation). ...feet from soil absorption system (Cesspool, Drainfield, etc.)....Structure will be located . 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 ^ns and specificatioqs submitted herewitf shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) moptlii^ ^ THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA ST A TE ST A TUTES.ignature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: 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. 7/(2/86 6O.n0 zlDated loreland Management (^icial Permit Fee $. '1 j llj^^Comments: 195676@ VICTOR LUNDCEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 ’^'iv’,— 'Tir 1■■vwT'^w^V^' »* '• ■•5White — Office Yeiiow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 ^—Fergus Falls, Minnesota 56537 application'Por site permit 1 /Permit No,.ifiNJ O 0 V\L. c. t V CLEGAL -L. yDESCRIPTION AND LOCATION TWP NameTWPRangeLake No.Lake Classif.Sec.Lake Name IDENTIFICATION: Please Print All Information Mailing Address— No. Street. City and State Zip No.Tel. No.Last Name InitialFirst iOwner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling ( ) Other Specify:, Units ] ( ) Other I Size ESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL: ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public (V ) Individual Well DIMENSIONS: ( ) Masonry ( ') Wood Frame ( ) Structural Steel ( ) Other — Specify Basement: ( ) Yes ( ) No Stories above basement: ...... Sq. feet (outside dimension) .... Bedrooms .1 1Baths..... 3 ;i Type of Roof: ■■ ^ r I CHARACTERISTICS:f \ ^ ^ ... square feet. Building set back from high water mark is. Land height above high water mark at building line is Water frontage is feet.Maximum depth of lotLot Area is feet. feet. (Building Line) feet . . 0Building set back from State highway right of way i : ..... feet — from road right of way is feet. Side yard is and feet.i .'.V.Structure will be located .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). ■j >. Structure will be located 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 herewitf shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. rw/s /S A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. C Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: 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. Dated Shoreland Management Official f iV €Permit Fee $. ■ 3 It 1 I. V w ( PComments:i ; ■ i 195676® VICTOR LUNDEEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 ! INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS jr MINIMUM Shall Be 4-Sq. Ft Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft. Ft. I OO Ft.Building Set Back from High Water Mark Ft. Ft. ^ Ft. Building Set Back from State Highway 50 Ft. 4n Ft.Building Set Back from Street or Road fO & ro Ft.Side Yard /A Ft/A-^ Ft, /6^ Ft. Rear Yard Occupied Building to Septic Tank 10 Ft. Ft.Occupied Building to Absorption System 20 Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments:f— li i ■ b'--57 - V ■ 44^ > Inspectors Signature 1- '-Q. Title 1~3oInspection Dated Agency VICTO* UiHDCC* ft CO . MiHTtftt. FfM«U* fALU. iUIIII. f White — Office Yeliow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 — Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT '7//Permit No,.LEGAL _> 'tt C Uii DESCRIPTION AND LOCATION TWP NomeTWPRengeSec.Leke No.Lake Classlf.Lake Name IDENTIFICATION: Please Print All Information Tel. No.Zip No.Mailing Address— No. Street. City and StateLast Name First Initial Owner NameContractor Architect Name, TYPE OF IMPROVEMENT:NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:t / 'Y V C /jC.4 { ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:. Units1*' ( ) Other ( ) Other Size IESTIMATED COST OF IMPROVEMENT $ PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Yes ( <{ No( ) Masonry ( ,) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public (. ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( )' Individual Well Basement: Stories above basement: Sq. feet (outside dimension) ! Baths nrr;.r.,Bedrooms Type of Roof:} rvi p />CHARACTERISTICS: r\/ .... feet.:z >' t square feet.- Water frontage is Building set back from high water mark is. Maximum depth of lot feet;Lot Area is feet. (Building Line) Land height above high water mark at building line is Building set back from State highway right of yvay.... ............................. and................................ feet .W(...Z..feet — from road right of way is •feet. Side yard is feet. .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). Structure will be located ) Structure will be located Agreement: I hereby certify that the information contained herein is correct and agree to do the proposed work in accordance with t)ie 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 herewitf shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUTES.4Signature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon thePermit: 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. Dated Shoreland Management Official Permit Fee $.?^ ..I V ‘ ’ pv A ‘ ..I ' 'r'rCommentsrJi.i. j .J W'A.,/Vs V:i 195676® VICTOR LifNDEEN CO.. PRINTERS. FERGUS FALLS. MINN.Form No. MKL-0771-002 INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS I MINIMUMShall Be Sq. Ft Lot Area (Square feet)Sq. Ft Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. Building Set Back from Street or Road 40 Ft.Ft. Side Yard &Ft.&Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank 10 Ft.Ft. Occupied Building to Absorption System Ft. 20 Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: ! .M--. - i ' rv-X ■Inspector's Signature Title Inspection Dated 19 Agency vicTON LuneccN k . GRID PLOT PLAN SKETCHING FORMfeet/inchesScale: Each grid equals Dated: 'b ^ At! KL Signature Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently on lot and any proposed structures. 7T“'' \5NX M.lA UlSil' 1 I ^ (A »7 i:riA I- ,II ! I i -I A 21S98 7®MKL-0871-029 VICTOH LUNDCEN CO . PBIMTt^S. ftRCuS fAll.5. MINM-