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Home My WebLink AboutSwan Lake Club_13000190112000 _ 22343_Shoreland Permits_APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office^ ' GOLDENROP - Inspector YELLOW -^Owner (after issue) PINK - Assessor PLEASE PRINT OR TYPE ALL INFORMATION Permit No. LAKE / RIVER NO.LAKE/RIVER CLASS SECTION TWP NO.RANGE TWP NAMELAKE/RIVER NAME U \ (3^ \ pr<^iYf rysit( S£Sy? !^yidu/*1 SU/^crtA/t Ira k<l^ <^(011? La PARCEL NUMBER (S) / 3 ~ n - olix - ooo LEGAL DESCRIPTION tor. d T Daytime Phone No.Last Name First Initiai Mailing Address 3V3 flag d- ^ fa !h Property Owner 7U- o6x5rt SJfContractor Lie. I ONSITE WATER SUPPLY Individual ( ) Public ( ) None NOTE: MN Rules Chpt, 4725 {MN Well Code) requires a 3' (minimum) structure setback to a weli. ONSITE SEWAGE TREATMENT SYSTEM{ ) Permit No. //c/A ( ) OTLSD * This permit is only vaiid alter verificatiort from the O.T.LS.D. that a conforming sewage system wiit be instaited to service this iot contact Roitie Mann at 864-5533. PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling ( 5) RCU/Year_____ (7 ) Add’n To Non-Dwelling Storage Structure (10) Other, (1 ) New Dwelling (4 ) MH/YR____ ( 3 ) 'Replacement Dwelling (6) Detached Garage (9) WOAS 'Existing Dwelling to be removed before. CHARACTERISTICS OF PROPOSED WOASCHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS OF PROPOSED NON-DWELLING Outside iU't''Dimension ^ y Ft. x / 7 ^ Setback to Lotline i 7S Ft. & 50O Ft." Setback to Right of Way BoQ Ft." Setback to OHWL 2a J Ft. Elevation Above OHWL ^ Ft. Setback to^Se^ )4nk / 3 j~ Ft. Setback to Drainfield Kl A~ Ft. Setback to Bluff ------ Ft. Maximum Proposed Height l2 Ft. Bathroom Proposed ( ) Yes (^ ) No Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to OHWL___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height Basement_____ Walkout Basement Total Bedrooms_ Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to OHWL___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height ( ) Boathouse ( ) Screen Porch ( ) Storage Structure Ft. X Ft."Ft."Ft. X Ft." Ft.&Ft."Ft.&Ft." Ft."Ft." Ft.Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Ft. Yes No Ft. Yes No ( ) Gazebo **ProjectA.otlines/Right-of-ways Must be Staked Onsite Spoil Disposal - □ Onsite (scale drawing required) □ Offsite □ Within Shoreland Area □ Outside Shoreland Area Grade/Fill/Excavation "Project/Lotlines/Right-of-ways Must be Staked Onsite□ Yes (scale drawing required) I^Tto CHARACTERISTICS OF LOT: ^ '(k ^-Yes ^ NoBluff Onsite.Lot Area.Water Frontage Ft. /.gs? rkly. 15"1.Impervious Surface Ratio:X100 =.% Total Impervious Surface Onsite (FT*)Total Lot Area (FTr)Impervious Surface Ratio 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 responsibility to inform the Land & ^source agemeqt office once the buiiding footings have been constructed. aDate:7*Signature of Property Owner I Date: Land & Resource Management Office *3S23r75^IPERMIT FEE $RECEIPT NO. jOLr Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application. c/-y i/Yi A.p ^ Lff ty I' Yj 'TI\ ,''1'h ^tComments:fft'/v <L \I Form No. BK — 0500-0201 304,202 • Victor LufXleen Co., Printers • Fergus Falls. MN • 1-800-346-4870 3 APPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE 121 W. JUNIUS AVE. • SUITE 130 Phone: (218) 739-2271 • TERGUS FALLS, MN 56537 WHITE-Office ' GOLDENROD - Inspector YELLOW - Owner (after issue) PINK - Assessor 1■■1 ■ ii>'3 m'-iLPLEASE PRINT OR TYPE ALL INFORMATION Permit No.I LAKE/RIVER NO.LAKE/RIVER CLASS SECTION TWP NO.RANGELAKE/RIVER NAME W(J Y\ ke^ TWP NAME pY<nhr/ tioTth f/<c- ryts.i ( hi/A,., hi *1 ~ 7 '^1 r I33L.11 '<£>LA-7 PARCEL NUMBER (S)E-911 ADDRESSO ado ~ n-old-pop S ^5 J 7l/< 6 LEGAL DESCRIPTION I/ /jif Ld\7Tr l^OL hdh/i1Or.iI First Initial Mailing Address Daytime Phone No.Last Name 1;9^ 3*^3 A/. La he. jloA <1 hi'^ S/937 Property Owner 7ii- o&xS 1FJK Contractor Lie.#1 a1 ONSITE WATER SUPPLY pQ Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM PROPOSED PROJECT (please circle the appropriate number) (2 ) Add’n to Dwelling (5) RCU/Year_____ (7 ) Add’n To Non-Dwelling ((^ Storage Structure (10) Other. ;! ( 3 ) ‘Replacement Dwelling (6) Detached Garage (9) WOAS (1) New Dwelling (4 ) MH/YR____ lojih( ) Permit No.__; ( ) OTLSD * This permit is only valid after verification from the O.T.LS.D. that a conforming seivage system will be installed to service this lot contact Rollie Mann at 864-5533. / [' i. ‘Existing Dwelling to be removed before CHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS OF PROPOSED NON-DWELLING CHARACTERISTICS OF PROPOSED WOAS Outside Dimension / 9 Setback to Lotline 3 7S' Ft. & S'OO Ft.“ Outside Dimension Setback to Lotline ___ Setback to Right of Way Setback to OHWL ___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height Basement_____ Walkout Basement Total Bedrooms_ Outside Dimension Setback to Lotline___ Setback to Right of Way Setback to OHWL___ Elevation Above OHWL. Setback to Septic Tank _ Setback to Drainfield__ Setback to Bluff_____ Maximum Proposed Height ( ) Boathouse ( ) Gazebo ' ' ^ "Z ^Ft. X / 7 ^ Ft.“Ft. X Ft."Ft. X Ft." Ft."Ft.&R.&Ft." Setback to Right of Way 5o0 Ft." Setback to OHWL XePO Ft. x:^Ft. Ft."Ft.” Ft.Ft.Ft. Elevation Above OHWL Setback to Septic 'fiink /3 C Ft. Setback to Drainfield (V ^ Ft. Ft.Ft. Ft.Ft. Ft.Ft. Ft.Setback to Bluff Maximum Proposed Height Bathroom Proposed ( ) Yes (X) No Ft.Ft. 12,__Ft.Yes No Ft. NoYes ( ) Screen Porch ( ) Storage Structure ■; **Project/Lotlines/Right-of-ways Must be Staked Onsite Spoil Disposal □ Onsite (scale drawing required) □ Offsite □ Within Shoreland Area □ Outside Shoreland Area Grade/Fill/Excavation **Project/Lotlines/Right-of-ways Must be Staked Onsite□ Yes (scale drawing required) aCNo CHARACTERISTICS OF LOT: Yes y NoBluff Onsite.Lot Area.Water Frontage .Ft.4f . rl-. /S'i" Impervious Surface Ratio:X100 .% Impennous 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 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. /■'i r-t-'Or O A (LL.LyB, .0.0 i c -i'O/7 A ^ - 7'/1djAj-Date:; J-ty(A.Signature of Property OwnerS/ II O! Date: Land & Resource Management Office/ 3 323^o/< 63VJ PERMIT FEE $RECEIPT NO. Ur Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application. ^ L uy i' Kj / r d V\t 0-y l/vU^ K , A vts 9Comments: f I'hd <L ilk \^2j-D) ‘ Av, r i d v\/ ‘1 corm No. BK — 0500-0201 304.202 • VKtor Lundeen Co., Printers • Fergus ^Is, MN • 1*600-346^70 N ■* SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations oils Structure Set Back from Ordinary High Water Level Ft. Ft. Structure Set Back from Top of Bluff Ft.Ft. C-^) Ft.Structure Set Back from Road Right of Way Ft. /Structure Set Back from Lot Lines Ft.&Ft.Ft.&Ft. /O'Structure Height Ft.Ft. Structure Set Back from SpptiC'Tank Ft.Ft./o o-y~ Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: r Inspector’s Signature Date of Inspection / /.do Time of Inspection ■p^roject Approved Date/Initial - • -..f'-' i’* V ■ ••r # 7 //7 Acre Parcel (Excep t ion J 4J% 1 1 i 'I « 1 ■sO *xNV I t > •• ^4 T> tv ! I r li11i :i r ■!1 ■:i •i--,. _.• •• ,:m3Ss1 >•s '■‘^i APPLICATION FOR SITE PEREIfllT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone:(218)739-2271 • FERGUS FALLS, MN 56537 WHITE - Office GOLDENROD - Inspector YELLOW ■ Owner PINK - Assessor S' U 3, (encuMO <V Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YESLOCATION ^fSio UKE NUMBER LAKE/RIVER PARCEL NUMBER (S)n-Oll^-OdO LAKE/RIVER NAME SECTION TWP NO. RANGE TWP NAME , GRADING / FILLING □ YES # OF CUBIC YARDS FIRE NUMBER S. '3'5Ce7>jgo IDENTIFICATION: Please Print All Information TELEPHONE NO. Mailing Address — No. Street, City, St^, and Zip Code )S MT] __________First ^ Initiai ^ f(A?U (Daytime)Last Name Property Owner NameContractor State Lie. it PROPOSED PROJECT ( ) New Structure(s) j^)^^ition(s) ( )MH/RV________________ PROPOSED USE ^.^i^Jwlling ( ) Non-Dwelling ONSITE WATER SUPPLY J^^Hfi^ividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ^j,^ijlndividual Permit # ( ) Collector Permit #_ ( jOTLSD* i£r: ( ) Water Oriented Accessory Structure (WOAS)YEAR CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING ( ) Utility Structure CHARACTERISTICS OF DWELLING Basement ( ) Walkout ( ) Attached Garage ( ) Existing Dwelling shall be removed on or before Outside Dimension, (N3 Boathouse ( ) Screen Porch( ) Detached ei^age( ) Dwelling ( ) Replacement Dwelling ^^^^dition to Dweiling ( )GazBtw ( ) Utility Structi^( ) Other Outside Dimension ( ) Other, Outside Dimension .Ft. X.Ft.Lotline Setbacks Ft.Ft.Ft. XSO H,Sf)Ft.&Lotilne Setbacks OHWL Setback .Ft.Ft.Lotline Setbacks OHWL Setback Bathroom:I/' ) Yes ( ) No \ (IJ^s / a complying Sewage System Required)Ft.IHWL SetbackTotal Bedrooms ^ Maximum HeigKw 35 story^Maximum Height / 10 ft. (1 story)MaxinTum Height Ft.story Impervious Surface Ratio,Sq. Ft.%,Sq. Ft. Impervious SurfaceLot Area Ft. (3’ minimum)Ft. Elevation of lowest floor above OHWLWater Frontage_______________ Structure setback to right-of-way ;2n Ft. Slope of lot .% 0 Ft. (10’minimum) (Sewage System Permit required before installation). Ft. (20’minimum) (Sewage System Permit required before installation). Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to septic tank Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System 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 Ordinance 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 Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. Signature of Owner / Lan(P6 Resource Management Office O/^ Dated: Dated: RECEIPT NO.PERMIT FEE $ ^ l\^U(LC Comments: a Form No. BK — 0597-002 290,821 • Victor Lur^deeri Co.. Printers ♦ Fergus Falls. MN • 1-800-346-A870 otAPPLICATION FOR SITE PERMIT LAND & RESOURCE MANAGEMENT OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS. MN 56537 WHITE GOLDENhOD ■ Inspector YELLOW - Owner PINK - Assessor ■/ G L 3, Mlfupn aj Permit No.LEGAL DESCRIPTION BLUFF ZONEAND □ YESLOCATION SECTIONLAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS TWP NO.RANGE TWP NAME l^v V I13DI X> GRADING / FILLING □ YES # OF CUBIC YARDS a NO PARCEL NUMBER (S)FIRE NUMBER'/- oii^-odor/;>V7fX IDENTIFICATION: Please Print All Information TELEPHONE NO. First Mailing Address — No. Street, City, State, and Zip Code (Daytime)Last Name Initial cxa hi- •,Property Owner T T-iG tcAyu^ V Jc^^ '>11y . (x. ^f:-t.. u / ^T{ LNameContractor State Lie. it PROPOSED USE '^welling ( ) Non-Dwelling { ) Water Oriented Accessory Structure (WOAS) ONSITE WATER SUPPLY (Individual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM (,') Individual Permit #__/ ( ) Collector Permit #___ ( )OTLSD* PROPOSED PROJECT ( ) New Structure(s) Addition(s) ( )MH/RV______________ YEAR CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING ( ) Detached Garage CHARACTERISTICS OF DWELLING /( 4 Basement ( )Waikout ( ) Attached Garage ( ) Boathouse ( ) Screen Porch( ) Utility Structure( ) Dweiling ( ) Replacement Dwelling j[>) Addition to Dwelling ( ) Existing Dwelling shail be removed on or before. ( ) Gazebo ( ) Utility Structun( ) Other Outside Dimension X .Ft. X .Ft.( ) Other. Outside Dimension XOutside Dimension.Fi'.&\Ft.x / I .Ft.Lotline Setbacks .Ft.t .Ft..Ft.xr\Q__Ft.jI Ft.&Lotline Setbacks .Ft.OHWL Setback Lotline Sefbacks/ yn V /r L'r\ X—/(;- <-7 > 'Y ' t! ( . ' ' X .Ft.;Ft.&\ OHWL Setback Bathroom: ( ' ) Yes ( ) No (If Yes / a complying Sewage System Required)OHWL Setback .FI. Total Bedrooms Maximum Height / 35 Ft. (2 story)Maximum Height / 10 ft. (1 story)Ft..Maximum Height story - X.Sq. Ft. Impervious Surface Ratio .%.Sq. Ft. Impervious SurfaceLot Area .Ft. (3’ minimum).Ft. Eievation of lowest floor above OHWLWater Frontage_____________ Structure setback to right-of-way..%.Ft. Slope of lotT U f .Ft. (10’mlnimum) (Sewage System Permit required before installation). .Ft. (20'minimum) (Sewage System Permit required before installation). .Ft. (10’minimum) (Sewage System Permit required before installation). Structure setback to septic tank_____________ Dwelling setback to Soil Absorption System___ Non dwelling setback to Soil Absorption System 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 pians 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 Ordinance 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 Management office once the building footings have been constructed. * This permit is only valid after verification from the O.T.L.SD. that a conforming sewage system will be installed to service this lot... Contact Rollie Mann at 864-5533. Dated: Signature of Owner Dated: Land & Resource Management Office /RECEIPT NO.PERMIT FEE $ Comments:HpTM (4{pI Form No. BK — 0597-002 290.021 • Vtctor Lundeen Co. Printer* • Fergus Falls. INSPECTION RESULTS Make all measurements and computations % 41Structure Set Back from Ordinary High Water Level Ft.Ft. Structure set Back from Top of Bluff Ft.Ft. +-AoStructure Set Back from Road Right of Way Ft.Ft. 5o^Ft.& Ft.Structure set Back from Lot Lines Ft.&Ft. Structure Height Ft.Ft. Structure Set Back from Septic Tank Ft.Ft. Structure Set Back from Absorption System Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level____________________2^^Ft.Ft. Land Slope at Building Line % % Inspector’s Comments / Sketch:, • O ■3^ fihC)N ir i f Inspector’s Signature //'A 99 t Date of Inspection Time Inspection