The URL can be used to link to this page

Home My WebLink AboutTwin Lake Landing_02000180128001_Shoreland Permits_Firefox https://onegov.co.ottertail.mn.us/admst/viewcard.php?card=3&ap... OTTER TAIL C O U N T Y ^T77 Land & Resource Management Phone (218) 998-8095 PERMIT TYPE LOT ALTERATION PERMIT PERMIT NUMBER 8977 PROPERTY OWNER Phillip L & Muriel Foster LAKE INFORMATION Twin DNR ID(S)382 LOCATION Parcel(s): 02000180128001 Township Name: Amor Township Property Address(es): 34554 CO HWY 74 Section/Township/Range: Sect-18 Twp-134 Range-040 Legal: 24.00 AC ALL G.L. 1 S OF HWY EX TR WORK AUTHORIZED Fill a 12x60 upland area in front of existing storage shed. No fill material to be placed in the wetland. Properly install silt fence between the filled area and the wetland. Stabilize disturbed areas. Must control and store water run off. Approximate fill area- Length: 60 Feet Width: 12 Feet Average Depth: 1 Feet Total Cubic Yards: 27 Located at west end of resort. Contractor- Amor Excavating Eric Babolian 02/08/2021 09:53 AM 0fc3aed 14d4afb9b99bdde60c9108bb9 19f0d2e2e9635569c8af848d86877419 02/08/2021 02/08/2022 Land and Resource Management Official/Date ISSUE DATE DATE EXPIRES NOTE: • This permit must be placed in a conspicuous place not more than 6 feet above grade on the premises on which work is to be done, and must be maintained there until completion of such work. • If the terms of this permit are violated, the entire permit may be revoked and the owner/contractor may be subject to legal prosecution. • Property Owner is legally responsible for all surface water drainage which may occur. • Topographical Alteration projects shall be stabilized within 10 days of the completion unless otherwise stated. • Timelines as set forth in Section IV.3.D of the Shoreland Management Ordinance shall be adhered to. • Notify Land & Resource Management when job is ready for inspection (218) 998-8095. 2/9/2021,8:44 AM1 of 1 Land & Resource Permit Applications https://onegov.co.ottertail.nin.us/view.php?id= 16179 Land & Resource Management Government Services Center 540 Fir Avenue West Fei]gus Falls MN 56537 OTFIR Tfill 218-998-8095OOUDTT-tDtOQCrOTA Site Permit Applications LOT ALTERATION PERMIT Permit # 8977, App. # 817, UID #16179 Vaiid: 02/08/2021 - 02/08/2022 Applicant Information Applicant Information;Name: Twin Lake Landing Resort Phone: {763 )6^ -3734 Email Address dirk.foster49@gmail.com Mailing Address 34554 Co. Hwy 74 Battle Lake MN 56515 I am the:Agent/Designer Is this Lot Alteration Permit Application for Multiple Properties? No Work Performed By Work to be performed by:Contractor Contractor's Contact Information Contractor Information:Name: Mike Harms Company or Buaness Name: Amor Excavating Phone: (218 )205 -2725 Email: amorexcavating @gmail.com Address 35061 295th Street Battle Lake MN 56515 Property Owner's Contact Information Property Owner Contact Information: Name: Vem and Muriel Foster Phone: (218 ) 4^ • 3440 Mailing Address 34648 County Hwy 74 Battle Lake MN 56515 Property Information Project Location: Primary Name/AddressProperty Attributes Property Address Legal Description Legal Description CityCityPrimary Address Line 1Parcel #Property Address Name 34648 COUNTY HIGHWAY BATTLE LAKE 02000180128001 34554 CO HWY PHILLIP L & MURIEL FOSTER BATTLE LAKE 7474 797148 Square FeetLot Area; Is this lot alteration permit part of a site permit application? Shoreland Information Associated Lakes: Lake Name DNRID Lake Class LRCD Twin 382 RD 56-382 Water Frontage; 950 Feet Bluff:No Proposed Project Fill approximately 1 ft of class 5 grai^l in area shown in the attached.Fill Project Description:Project Type: 2/9/202 li'8:45 AM1 of 4 Land & Resource Permit Applications https://onegov.co.ottertail.mn.us/view.php?id= 16179 Area to be Cut/Excavated Length:0 Feet Width:0 Feet Average Depth:0 Feet Total Cubic Yards:0 Length:0 Feet l-Caltiut^tg I Width:0 Feet A\erage Depth:0 Feet Total Cubic Yards:0 Feet0Length:0 Feet Width: I Calculate | Average Depth;0 Feet Total Cubic Yards: 0tc^cuieta,:! Walk-Out Basement Project Length:0 Feet Width:0 Feet Average Depth:0 Feet Area to be filled/Leveled Length:60 Feet Width:12 Feet Average Depth:1 Feet Total Cubic Yards: ^Please Describe |*Calt(ilata | Filled/Leveled Area: Please see attached. Located at west end of resort. Length:0 Feet Width;0 Feet Average Depth:0 Feet Total Cubic Yards:0 Length:0 FeetI PalsUlate I Width:0 Feet Average Depth:0 Feet Total Cubic Yards: 0 r-taicuiatB I Backfill at Foundation 0 Feet Average Width:Linear Length:0 Feet Backfill Total:00 Feet Average Depth: F^aMulate I Total Earth Moving Request Total Earthmov^ng Request:27 Cubic Yards Culvert and Road Authority Culvert?No Road Authority Approval: Impervious Surface - Buildings 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Dwelling Existing:0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feel 0 Square Feet Dwelling Proposed: Attached Garage Existing: Detached Garage Existing: Storage Shed Existing: Water Oriented Accessory Structure Existing; Attached Garage Proposed: Detached Garage Proposed: Storage Shed Proposed; Water Oriented Accessory Stmcture Proposed: Recreational Camping Unit Proposed: 0 Square FeetRecreational Camping Unit Existing; 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Total Building Existing Impen/ious: 0 Square Feet I Calcula^J Miscellaneous Existing:Miscellaneous Proposed; Total Building Proposed Impervious: Total Building Existing Impervious: 0 Square Feet 0 Square FeetTotal Building Proposed Impervious: Total Building Impervious Surface: 0 Square Feet Impervious Surface Calculation - Buildings Total Building Existing Impervious: 0 Square Feet 0 Square FeetTotal Building Proposed Impervious: Total Building Impervious Surface: 0 Square Feet 797148 Square FeetLot Area: Impervious Surface Ratio: Buildings Impervious Surface Percentage: 0.0000 0.00 % Impervious Surface - Other 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Retaining Wall(s) Proposed: 0 Square Feet 0 Square Feet 0 Square Feet Total Other Proposed Impervous; 0 Square Feet Deck(s) Proposed:Deck(s) Existing:0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet p Square Feet 0 Square Feet 0 Square Feet p Square Feet | Patio(s) Proposed:Patio(s) Existing; Sidewalk(s) Proposed:Sidewalk(s) Existing: Landing(s) Proposed:Landing(s) Existing: Driveway(s) Proposed:Driveway(s) Existing; Parking Area(s) Proposed:Parking Area(s) Existing: Retaining Wall(s) Existing: Landscaping Proposed;Landscaping Existing; Miscellaneous Existing;Miscellaneous Proposed; Total Other Existing Impervious; Total Other Impervious Surface;0 2/9/2021, 8:45 AM2 of 4 Land & Resource Permit Applications https://onegov.co.ottertail.mn.us/view.php?id= 16179 Impervious Surface Calculation - Buildings & Other Total Building + Other Existing Impervious: 0 Square Feet Total Building + Other Proposed 0 Square Feet Impervious: Total Building + Other Impervious 0 Square Feet Surface: Lot Area;797148 Square Feet Building Other Impervious Surface Ratio: 0.0000 Building + Other Impervious Surface Percentage: 0.00 % Shore Impact Zone Impervious d Square FeetBuilding(s) Existing;Building(s) Proposed:0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Deck(s) Existing;0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet 0 Square Feet Deck(s) Proposed; Patio(s) Existing;Patlo(s) Proposed: Sidewalk(s) Existing;Sidewalks(s) Proposed; Landing(s) Existing;Landing(s) Proposed: Dri>eway(s) Existing: Parking Area(s) Existing; Retaining Wall(s) Existing: Driveway(s) Proposed: Parking Area(s) Proposed: Retaining Wall(s) Proposed: Landscaping Existing:Landscaping Proposed: Miscellaneous Existing:Miscellaneous Proposed: Total Existing ImperN^ous in the Shore Impact Zone: Total Impeoiious in the Shore Impact Zone: Total Proposed Impervious in the Shore Impact Zone: 0 Square Feet [&Calcu<ate^ Documentation PLEASE NOTE PROPOSED PROJECT AREA MUST BE STAKED File 1: ^ Fill_Request_-_West_End_of_Resort.docx Documentation: Total Impervious Surface to Determine Fee: 0 Square Feet Total Earthmoving Request to Determine Fee: ^ Cubic Yards Applicant Approval Applicant Signature:Dirk Foster Date Signed:01/29/2021 Please check to approve:I understand that checking this box constitutes a legal signature Terms MINNESOTA STATUTE 15.99, SUBDIVISION 2 I UNDERSTAND THAT IN ACCORDANCE WITH MINNESOTA STATUTE 15.99, SUBDIVISION 2, OTTER TAIL COUNTY HAS UP TO SIXTY (60) DAYS TO REVIEW AND APPROVE OR DENY THE PERMIT APPLICATION. DURING THE COVID-19 PUBLIC HEALTH EMERGENCY DECLARATION, OR UNTIL DECEMBER 31, 2020, WHICHEVER COMES FIRST, IN ACCORDANCE WITH MINNESOTA STATUTE 15.99, SUBDIVISION 3 (F), OTTER TAIL COUNTY HAS EXTENDED THE REVIEW TIME BY AN ADDITIONAL SIXTY (60) DAYS, AND HAS UP TO ONETHUNDRED AND TWENTY (120) DAYS TO REVIEW AND APPROVE OR DENY THE PERMIT APPLICATION. Notes The lot lines and project area(s) must be identified & staked onsite. If project disturbs more than 1 acre of land, you must obtain a General Storm Water Permit from the MPCA. Agreement I hereby certify that the information contained herein is correct and agree to do the proposed work In accordance with the description abo\« 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. Once Permit is approved, I also understand that this permit is valid for twelve (12) months from the date of approval unless otherwise indicated on permit. Invoice #10074 (01/29/20211 Charge Cost Quantity Total Topographical Alteration Fee #1 (0-20 cubic yds)added 02/04/2021 2:46 PM $80.00 $80.00X 1 Grand Total $80.00Total $80.00Payment 02/08/2021 $0.00Due Approvals 2/9/2021, 8:45 AM3 of 4 https://onegov.co.ottertail.mn.us/view.php?id=16179Land & Resource Permit Applications Approval Signature i Emma Barry - 01/29/2021 10:29 AM i883d947f510e0dca42fa0170c6746313 I653b8492f39396919elbc51ffeal6a6e #1 Received and Assigned» i I Kyle Westergard - 01/29/2021 10:54 AM 9f8b784750170671ba0e9373c978d68b ael2d5966ebf7a7043285dl361623d21 #2 Permit Review #3 Permit Review Eric Babolian - 02/08/2021 9:53 AM249a66fefd3el55546f2610f994790f9 ccede77d895876fc639e6d535d40e985 Eric Babolian - 02/08/2021 9:53 AM I OfC3aedl4d4afb9b99bdde60c9108bb9 I19f0d2e2e9635569c8af848d86877419 #4 Permit Issuance Public Notes Text: File(s):^ Internal Notes Text: ■■ File(s):;- Print View 2/9/2021,8:45 AM '4 of 4 Land & Resource Permit Applications https://onegov.co.ottertail.mn.us/view.php?id= 16179 Approval Signature i Emma Barry - 01/29/2021 10:29 AM !883d947f510e0dca42fa0170c6746313 653b8492f39396919elbc51ffeal6a6e #1 Recei\ed and Assigned» #2 Perniit Review Kyle Westergard - 01/29/2021 10:54 AM 9f8b784750170671ba0e9373c978d68b ael2d5966ebf7a7043285dl361623d21 #3 Permit Review Eric Babolian - 02/08/2021 9:53 AM 249a66fefd3el55546f2610f994790f9 ccede77d895876fc639e6d535d40e985 Eric Babolian - 02/08/2021 9:53 AM0fc3aedl4d4afb9b99bdde60c9108bb9 19f0d2e2e9635569c8af848d86877419 #4 Permit Issuance Public Notes Text: File(s);i-■ Internal Notes Text: File(s)::- Print View■ 2/9/2021, 8:45 AM4 of 4 TWIN f ■ OTTER TAIL COUNTY Grade & Fill Permit # 6615 PROPERTY OWNER LAKE NO. SEC. W, TWP. NAME CO Vs^C-C \u.yvLEGAL DESCRIPTION: V-.C I w WORK AUTHORIZED 3=,VsV \Wvs v*a‘vn\ No*.— ^ CWtPs, \o«—c»v N iCo “ K Q VJ^»>w. Q-vox. Q*\Cu.Osy-^^V7 . rc^^N.0t\iv ' NOTE; This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on \vhich work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MANAGEMENT, 218-998-8095 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. 1. EARTHMOVING SHALL BE DONE BETWEEN & ^-6-0> 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur, 4. No fill shall enter or be taken from the beds of public water without a valid permit from the MN Department of Natural Resources. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 6. Erosion control measures must be implemented prior to any topographical alterations.% APPLICATION FOR GRADE & FILL 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 \ Permit No.PLEASE PRINT OR TYPE ALL INFORMATION LAKE/RIVER #LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP. NO.RANGE TWP NAME C/OuJ /)Lex r~ PARCEL NUMBER(S)PROPERTY (E-911) ADDRESS 0:^000 ( 80\~:^ \ LEGAL DESCRIPTION A\\ Uc~\r 1 5» V\Tryjo --K. Last Name First Initial Mailing Address DAYTIME Phone No. Co. VttsL. Lex ^(?S» \^S»1 ^16-Property V' 5 ^IHOOwner Vx V1 ^ C, 0 WContractor Name CoA-\kj^>^ -h-(jL Ua \-Ce~VXT Lie.# Date Stamp ^^CBIVBD 2 3 2013 resource NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. L&R Initial PROJECT REQUEST (You may use the grid on back for required scale drawing): DESCRIBE YOUR PROJECT(S): To ^ \ <r U ex- erT C. ^CxvccA LcvKa. ^\dJjCl V\ / 6 O -C~V »V\ . R-<g^CXe,c V S DETAILED INFORMATION: AREA TO BE CUT/EXCAVATED:Yds^Ft. X Ft. X Ft. -27 = Length Ave. DepthWidth Yds^WALK-OUT BASEMENT PROJECTS: (Outside of the building foundation) Ft. X Ft. +27 =Ft. X Length Ave. Depth Ft. X Q Ft. X /.^ Ft. +27= Yds^ Ave. Depth Width /OOAREA TO BE FILLED/LEVELED: Length Width Yds^TOTAL EARTHMOVING REQUESTED = BACKFILL AT FOUNDATION;Ft. Ft. Max. Depth Distance From Foundation CULVERT:If Yes, must indicate size and location on drawing. Yes No ^SCANNEDIMPERVIOUS SURFACE:% / '^K062011 / SIGNATURE OF PROPERTY OWNER/AGENT FOR OWNER RECEIPT NUMBERDATE ■ Tax parcel Number(s) -»' Drawing must be to scale. Drawing shall identify project and include the setbacks to all of the existing and proposed lotlines, road right-c ordinary high water level(s), structure(s), septice tank(s), drainfield(s), bluff(s) & wetland(s). Must also include all proposed topographical altev I %Scale \Impervious Surface \i I : i .... ”1 ...........( i iI !! !I Ii \ i !: i GrdSc\)dt.<^I Ii i>CQc. \ ,/7 I/'. ••f( Ip ;s ;•>i ! I j I i " ^0" ^ '' r J P f A! ■■! ; !CjvA\V^^c\ ^ SCAHHED i C-8Signature of Pro^rt^Owner Date BK — 050S 322.369 ■ Vicra LundsenCo. Pr.nlera ■ Fetsus Fa'S. M.V • 1^00.346^820 Wp|LICATION for grade & FILL PERMIT i LAND & RESOURCE MANAGEMENT, COUNTS OF OTTER TAIL o GOVERNMENT SERVICES CENTER, 540 WEST FIR^flf GUS FALLS, MN 56537 218-998-8095 _ WWW. CO. otter-ta i I. m n. u s . i- Permit No.PLEASE PRINT OR TYPE ALL INFORMATION LAKE/RIVER #LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP. NO, RANGE TWP NAME Awid'f'I8Thi\v\\SH M .040 PROPERTY (E-911) ADDRESSPARCEL NUMBER(S) LEGAL DESCRIPTION Last Name__________________DAYTIME.Phone No;First Initial Mailing Address ^ aiMV jL-Lf Property - 3 0 CVvvii.Wu-sa.vv CovA'sVir'iAcVi'ftv Mul.-- 8S 1HEUBIK3^ZS Contractor Name WSTHfLie. # NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. Received L&R Official DATE PROJECT REQUEST (You may use the grid on back for required scale drawing): Q(0Q |i VCXCOlVJvAjP DESCRIBE YOUR PROJECT(S): To Q\ Ual A'VVv \/^QrxC^^oo 1 Wfi/TtV \-P\r. /44.Kt'uc<\r tV\CL Qj CKCXVA. 3 , fcV At 4^.0 L)vJ ooC\A \ \ \C5L \t) \ack\<J^O-A. ^ CK•Vo Y* o y\AO A r o.WLpjg'r <tV-e4=.rx\A g> \A DETAILED INFORMATION: mA Yds^AREA TO BE CUT/EXCAVATED:Ft. X Ft. X Ft. - 27 = Length Width Max Depth KlA Yds^WALK-OUT BASEMENT PROJECTS;Ft. X Ft. X Ft. - 27 = Length Width Max Depth I'A Ft. X . ^ Ft. - 27= 2£>0 Max Depth AREA TO BE FILLED/LEVELED: trOoAs Ft. x ,. Length Width ' TOTAL^ARTHMOVING REQUESTED MA Ft. Yds^ .S'X =Yds^ SLOPE OF BACKFILL AT FOUNDATION:Ft. Max. Depth Distance Extended From Foundation yCULVERT:If Yes, must indicate size and location on drawing. Yes No TYPE OF SOILS AND/OR FILL MATERIAL: (l\ aS$ /7 SIGMTURE of PROPERTY oWnEB/AGENtVoR OWNER 3«l7 DATE RECEIPT NUMBER BKOO J_l_a ■J-l %I'iiiwIT .1. tTax-parcel-Nu'mbe'r{s)L 1tt tLjDrawing must be to scale:[Drawing shall laeritify pijoject and'include the setbacks to all bfi the existing and , ordinary.highlwater|ldvel(s)J.structure(s),.septice-tank(s)tdrainWld(s),.'bluff(s).&.wetlMd('s)i.Miist.aiso.inc'iu'dei^. I I I I______ 1 I } I I I I I I I -I I [ I I I [.................................................................... r _ix i zidzpp: jz]:: sz _ il^i zrlz i t)roposed'lotlinesrf(Dad[rigtit-df-^av(s);~ prdpose'd.tojDograph c^.alteratiohs— Scale Impervious Surf^ s i-e.v>^V N.T <e I—i hjUTi5:OvAiVv:]"On 1 I i I IT i i I taMim&k bate Ivl '800-346J870-BK-^0505-329,610-etc -Lundeen Coi Printers-Fergus Falls..MN-*—1 :xL.r TT r WHITE - Office APPLICATION FOR SITE PERMIT 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 PLEASE PRINT OR TYPE ALL INFORMATION Permit No. TWP NO.RANGE TWP NAMELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER SECTION nP /8 I /3^ I 4o or PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) CryOZ-COO-id- 0123-oo\ LEGAL DESCRIPTION M(SL I ^ q-^ tf^y 7 SR^4, Sir Daytime Phone No.First Initial Mailing AddressLast Name ^^5:57 cry tiuy 7V S^TTlc ^6.S'/S'FbsTrr (^A2j2U PProperty Owner f 3^^^3 Deer l3(jl rflf /(z , /4/ 5/ Sj n-. SatoBr-nw'}, Contractor Name Lie.# w S /770 z/?o PROPOSED PROJECT {please circle the appropriate number) (1 ) New Dweiling ( 4 ) MH/YR ( 7 ) Add'n To Non-Dweiiing (10 ) Non-Conf. Replacement (identify^ /Tj^ther(ij^v) /KIS7^|I-(yV^ Q?SerAfk '■^fexl^ing Dwelling to be removed prior to_____C ONSITE SEWAGE TREATMENT SYSTEM (W^ermit No. /UnO ONSIT^ WATER SUPPLY (|^)/tfidividual ( ) Public ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3' (minimum) structure setback to a well. (2 ) Add’n to Dwelling ( 5 ) RCU/Year_____ (8 ) Storage Structure ( 3 ) ‘Repiacement Dweiling (6 ) Attached / Detached Garage (9) W.O.A.S.( ) OTWMD 'Must have Sewage System Approval from OTWMD prior to issuirtg Site Permit. Contact Rollie Mann at 218-864-5533 CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must tnclude Attached Garage) Outside Dffnension _ Sq. Ft. OZ Setback to Lotline\^ Setback to Right of W Setback to Ordinary High Vtfqter Level /,7. Ft. Elevation Above Ordinary Higlntetidr Setback to Septic Tank Setback to Drainfield Setback to Bluff___ Total Bedrooms / Maximum Propqjied Height Roof Chang Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side prolile required) { ) No •4 ^ Ft."ZO Ft.x Ft. XFt./Ft."Ft. XQ4oSq. Ft. Setback to Lotline /00~L Ft. & /oO Ft.” Setback to Right of Way ycX-7~f~ pt." 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 Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Prior to Appiication / inspection Ft.&Ft." Ft.&Ft."Ft.'/ iLS Ft." Setback to Ordinary High Water Level Elevation Above Ordinary High Water Level _ Setback to Septic Tank Setback to Drainfield / Ft. Setback to Bluff Ft. Maximum Proposed Height ________ Roof Change ( ) Yes ( X3 No Bathroom Proposed ( ) Yes (^) No 3Level Ft.Ft.33-Ft./Ft.Ft. Ft.Ft. zia Ff^Ft.Ft. Ft.) Yes ( ) No ( ) Screen Porch ( ) Storage Structure ■ Must include on scale drawing, additional Permit may be required. Topographical Alteration / Earthmovina None ^^0 Cubic Yards CHARACTERISTICS OF LOT: 2 S At rr S □ 21 Cubic Yards - 299 Cubic Yards'□ 300 Cubic Yards or More'or Less ' /xc3j9'Ip6q Bluff ( ) Yes {^) NoSq. Ft..Ft.Water FrontageLot Area ‘O'Z Totai Lot Area (FT') Impervious Surface Ratio:X 100 =,%Impervious Surface RatioTotal Impervious 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 responsibility to inform the Land & Resodre^anagement office once the building footings have been constructed. 7^ 9 I0l9,j69 Date: Signature of Property Owner / Agent for mer Date:l43^SJlolk%iSi99MLand & Resource Manageme^^f^^ ^ ^ RECEIPT NO.PERMIT FEE $PROJECT(S) TOTAL SQ. FT. pLUjip nm/-.. S''IMJiiljiajD L W kffpAj/rJ (L ■ imComments: \ Form No. BK — 1003-0407 329.582 • Victor Lundeen Co., Printers • Fergus Falls. Minnesota WHITE - Office GOLDENROD - Inspector APPLICATION FOR SITE PERMIT 0&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. 0n PLEASE PRINT OR TYPE ALL INFORMATION 5 RANGE TWP NAMELAKE/RIVER CLASS HD SECTION TWP NO.LAKE/RIVER NAMELAKE / RIVER NO. ^ OT / PROPERTY (E-911) ADDRESSPARCEL NUMBER (S) ^55V (vy Moy 7V rrit■ "VJO "Id- Ol2d~0O\■ j XfLEGAL DESCRIPTION /juy ^ Sir He/ Daytime Phone No.First Initial Mailing AddressLast Name SWSSV Cf y /<V_____ S^TtI-c jh hJ i; )Tr r ^ o ip't rJ ^ j_____ IZ44JU7) .Jn/tWjKh RProperty Owner Qi-IOSiii D(^r/ /Jd Ks TTli- /^r /(fUQ 5/ 5 ~ R/3u/'Contractor Name Lie.# -T'S ST~no PROPOSED PROJECT (please circle the appropriate number) (2) Add’n to Dwelling {5) RCU/Year______ (7) Add'n To Non-Dweiling (8 ) Storage Structure (10) Non-Conf. Replacement (Identify)___________ (11) Other (identify)________ 'Existing Dwelling to be removed prior to______ ONSITE SEWAGE TREATMENT SYSTEM ONSITE WATER SUPPLY ( ) Individual ( ) Public ( ) None NOTE: MN Ruies Chpt. 4725 (MN Weli Code) requires a 3’ (minimum) structure setback to a weii. (3) *Repiacement Dwelling (6 ) Attached / Detached Garage (9) W.O.A.S, (1 ) New Dwelling (4 ) MH/YR____(' ) Permit No. _ ( ) OTWMD ‘Must have Sewage System Approval trom OTWMD prior to issuirrg Site Permit Contact Rollie Mann at 218-864-55337>v>U'' tT CHARACTERISTICS OF PROPOSED W.O.A.S. (WATER ORIENTED ACCESSORY STRUCTURE) Outside Dimension CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension CHARACTERISTICS OF PROPOSED DWELLING (Must Include Attached Garage) Outside Dimension Sq. Ft. Setback to Lotline Ft. X i - Ft."Ft. X Ft.*'Ft. X Ft." Sq. Ft. ■ Setback to Lofiine Setback to Right of Way ^ Setback to Ordinary High Water Level 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 Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Gazebo **Project/Lotllnes/Right-of-ways Must be Staked Onsite Prior to Application / Inspection Ft.&Ft."Ft.& Ft." 4/'Ft."Ft.&Ft.".' Setback to Ordinary High Water Level ■'-P Ft. Elevation Above Ordinary High Water Level Setback to Septic Tank__ Setback to Drainfield Setback to Bluff Total Bedrooms Maximum Proposed Height Roof Change ( ) Yes ( Basement ( ) Yes ( ) No Walkout Basement ( ) Yes (side profile required) ( ) No Setback to Right of Way f Ft."Ft." Elevation Above Ordinary High Water Level Ft. _ Ft.^^ Ft. ",Ft.Ft. Ft. Setback to Septic Tank Setback to Drainfield _ Setback to Bluff_____ Maximum Proposed Height —. O FtJ Roof Change ( ) Yes ( ■ ) No Bathroom Proposed ( ) Yes ( ) No 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: Bluff ( ) Yes ( ) NoFt.Sq. Ft.Water FrontageLot Area, Impervious Surface Ratio:,%X100 = Total Lot Area (FT=)Impervious Surface RatioTotal Impervious 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 responsibility to inform the Land & Resource Management office once the building footings have been constructed. Date: Signature of Property Owner / Agent for Owner Date:4/ Land & Resource Management Office PERMIT FEE $RECEIPT NO. 'PROJECT(S) TOTAL SQ.FT., 7/tj/jmiJr'/C f. -r/J <Comments:L Irin■/ /?: //-■ / •' -L ' ii--*' y n.' / 329,582 • Victor Lundeen Co.. Printers • Fergus Falls,Form No. BK — 1003-0407 SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations Structure Set Back from Ordinary High Water Level JL ^ ^Ft.Ft. 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. * /C Ft.Ft.Structure Height Ft.Ft.Structure Set Back from Septic Tank Ft.Ft.Structure Set Back from Drainfield ^ t- Elevation Of Lowest Floor Above Ordinary High Water Level____________________7 Ft.Ft. Land Slope at Building Site %% Inspector’s Comments / Sketch: nofFice/ (d>V Oo•4:—I \ / I Inspector’s Signature ^ L I/O Date of Inspection /o/7 Time of Inspection i^’foject ApprovedP(/r Date / Initial SCALE DRAWING FORM 000-1^ -OI Z6 -oo\ 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. I (2?rtn - S'% Impervious Surface Ratio (Must Complete Worksheet On Other Side) Scale O^Cic ^ I 1 O'O V rv~7^ i i z^S s. >i ■; I I Q i i i1 i: i i!I /o-/?/g-q i DateSignature of Property Owner [BK — 0207 329,086 • Viclor Lundeen C^„ Printers • Fergus Falls. • 1-800-346^70ii V IMPERVIOUS SURFACE CALCULATION WORKSHEET: List of Onsite (Existing and Proposed) Impervious Surfaces (must be shown on scale drawing): S6oo Ft2Structure(s): O Ft2Deck(s): , Qo O Ft2Driveway(s): 9oo Ft2Patio(s): Ft2Sidewalk(s): -e-Ft2Stairway(s): 50 Ft2Retaining Wall(s): R2Landscaping: (Plastic Barrier) Other:Ft2 QQQ Ft2TOTAL IMPERVIOUS SURFACE: LOT AREA: {SC.'TeS Ft2 .0 %X100 = TOTAL IMPERVIOUS SURFACE IMPERVIOUS SURFACE RATIOLOT AREA APPLICATION FOR GRADE & FILL 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 Permit No.PLEASE PRINT OR TYPE ALL INFORMATION LAKE/RIVER #LAKE/RIVER NAME SECTIONLAKE/RIVER RANGETWP. NO.TWP NAME>CLASS }n5 PARCEL NUMBER(S)PROPERTY (E-911) ADDRESS LEGAL DESCRIPTION . L AA Last Name -____________First _Initial Mailing Address DAYTIME Phone No, Property Owner 74^2Contractor Name AH Lie.# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of land you are required to obtain a General Storm Water Permit from the MPCA. Received L&R Official DATE PROJECT REQUEST (You may use the grid on back for required scale drawing^: DESCRIBE YOUR PROJECT(S): ^z.hi^Lc}~ 27 j^Uch- J^f^/ fl7C-rc=- isy ^ /ViT^u' i/eU<d^V7y)/W * oi.Jr A‘d^?ke-)' L^S\ ^xrr ^ A/e<^X A'/p jfftll RrzY) O t^pcr'T'iy/ ^ J Sh^k: .D^'C^ A/(xh^L(A'AO c/ r> yo<r c DETAILED INFORMATION: AREA TO BE CUT/EXCAVATED:Ft.Ft.Ft. Length Maximum DepthWidth Ft. ^ Ft.;2'AREA TO BE FILLED/LEVELED;Ft. Maximum DepthLengthWidth / 7-’SLOPE OF BACKFILL AT FOUNDATION Ft. Ft. Distance Extended From FoundationMaximum Depth CULVERT:If Yes, must indicate size and location on drawing. Yes No r j \/TYPE OF SOILS AND/OR FILL MATERIAL: / / 7 'TOTAL CUBIC YARDS OF EARTHMOVING REQUESTED: RECEIPT NUMBERSIGNATURE OF PROPERTY OWNER/AGENT FOR OWNER DATE BK0106 i ■ -i. Tax parcel Number(s) Drawing must be to scale. Drawing shall identify project and Include the setbacks to all of the existing and proposed lotlines, road right-of-way(s), ordinary high water level(s), structure(s), septice tank(s), drainfield(s), bluff(s) & wetland(s). Must also include all proposed topographical alterations. %Scale Impervious Surface i I I : /c2 //'/tcf 7^ I £fz<- I ii! i ;! r»;i ! I :: ;I ((I ' P/ p)^\^ 111I F:l> n:n 1 I1^S ^ >r \t signature of Property Owner Date BK — 0505 322.369 • \teior Luftd-en Co n-ip.? . Pe.ous P& 's mn • i 800-:WF.4RfC Grade & Fill Permit #nq gasae PROPERTY OWNER ' LAKE NO. SEC. TWP. NAME v»*y Y~o r So O ^AU (oC^ ILEGAL DESCRIPTION: WORK AUTHORIZED \ <r^ <Mx.\!>-V\yv v>j'v4~K . '|2_v.\b -*s_ f “2- x-J 'i cLa- Id 3oo^ ( 0 r\ (^Y\v^vv ^ \v\^I Oo/ 7^/. C/(^ ftt. C^w /^ // ^Vr>»w|p-^VA^ A V-<xvAcV ^2-oe) ' VUyrs C.Vv'vs-V‘\v/> S^v-x — OoY--~Wv^VvLy\A V\V>-CTY NOTE; This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, & shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MAN- AGEMENT, 218-739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. c/«A 1. EARTHMOVING SHALL BE DONE BETWEEN S~-qS^oL & 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. ^ - ({ '■ ( 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public water'without a valid permit from the ■ ^rj -.••-I APPLICATION FOR GRADE & FILL PERMITLAND & RESOURCE MANAGEMENT,;,fc0UNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 54(TiWEST FIR, FERGUS FALLS, MN 56537 218-998-8095, j |wwv^bo.otter-tail.iTin.us PLEASE PRINT OR TYPE ALL INFORMATION I ■ ' i> Permit No. ; . TWP NAME“ LAKE/RIVER '.SECTION -class/TWP. NO. RANGELAKE/RIVER #LAKE/RIVER NAME PROPERTY (E-911) ADDRESSPARCEL NUMBER(S) /? o Xoc>oi9c> / 7.Soe> / LEGAL DESCRIPTION 7^/ft/Jy 0/&.L. ! 5 ^ T DAYTIME Phone No.First Initial Mailing AddressLast Name^stcr MuticJ EProperty Owner L ::2»0-84^'-6 Go. b 3>C V\,>^vs Wm^m. (^ms^v*uC/Kv^'^Contractor Name Wct\cg. ^Gs>is~Lie.# NOTES: 1. The lotlines and project area(s) must be staked. 2. If project disturbs more than 1 acre of iand you are required to obtain a Generai Storm Water Permit from the MPCA. Received DATEL&R Official PROJECT REQUEST (You may use the grid on back for required scale drawing): DESCRIBE YOUR PROJECT(S): '7~0 /? i 4Va c'W‘?.G ^ I 'ftuL\iW \ CK\juek lolrricLa., /4\^0 AvK\A/\^sVe>r oor^cx.. CK LJUi CX OGT I : DETAILED INFORMATION: Ft.Ft.Ft.AREA TO BE CUT/EXCAVATED:../■'V Maximum DepthWidthLength I . ^ Ft.SOO Ft.Ft.AREA TO BE FILLED/LEVELED: I Maximum DepthWidthLength Ft.Ft.SLOPE OF BACKFILL AT FOUNDATION: Distance Extended From FoundationMaximum Depth ;CULVERT:If Yes, must indicate size and location on drawing. Yes No TYPE OF SOILS AND/OR FILL MATERIAL: ^ 0 Q C Ly^<^.TOTAL CUBIC YARDS OF^ARTHMOVING REQUESTED:i i ZLI S'- P, '0 (o£!RECEIPT NUMBERDATESIGNATURE OF PROPERTY OWNER/AGENT FOR OWNER/y BKO106 11 •■-l-L ■J.t --■i H- |Taxparcel|lu'mbe'r(s|)-|-| “ ~|Drawing~n iust be to scale: Drawing shaJI identify project and include" He setbacks to all ot the existing^nd prdposed'lotlinesn'oad ordinarpii; ih water..level(s),ls^i!icture(siCseptice.tank(s)pdranfield(s);.bi jff(s).&lvi^tlan'd(s^Must'.aiso.inclLiije.airprppose‘d.to^gr^ ■j_X i -rigHrof-way(s)-r cal-alteratiohs'.- !'X.i^ i.Tt Scale I mperviousjSijfface4 •'i-: i-t '1 li Tlitii I^1- S:i A h V I1a1$iJ IgaWhJ II/ m + T I I •V i Wii I.\.\ T 0 k\ •r t 1 m L J- 7[I lltil4 I2\'A \rj f^'/I E£ii\vAiI 1 I 7 / V'i 9 t 3i I A(y M H u II e«Axn mmm s-ty m +Slg^iature of Rr^irty Owner Date 9-?-,Vc;0505-BK..322 36 Col-Pflnters.Lurtdeen js Saus, MN__i-soo-s^e^aaro.I■|II Grade & Fill Permit #ns save PROPERTY OWNER I Lk Lovv^A^wft.________________ LAKE sec. i ^ TWP. NAME A rv^dV Ca C» i Co kwV^_____42--*^ >S -LEGAL DESCRIPTION: S I *. JLl o^wv'V* T^o-V*ra.v<^\ Q^wc>>4- <Sl v\v»-Vio<»»^ o^’i C- ^ Y*^v -____________ WORK AUTHORIZED /'On. VT<^ o Ck, A ♦% VM.O* tv>> *AoVvw CV^r’l^Ar•1^.^Q4v-v—CLov^Wv^oVo NOTE: This card shall be placed in a conspicuous place not more than 4 feet above grade on the premises on which work is to be done, &" shall be maintained there until completion of such work. NOTIFY LAND & RESOURCE MAN AGEMENT. 218-739-2271 WHEN AUTHORIZED WORK HAS BEEN COMPLETED. 1. EARTHMOVING SHALL BE DONE BETWEEN i 9-V-03iaiia..-.-: » ■ V 2. Entire area shall be stabilized within 10 days of completion of any earthmoving. 3. Owner is legally responsible for all surface water drainage that may occur. 4. No fill shall enter or be taken from the beds of public water without a valid permit from the MN Department of Natural Resources. 5. If the terms of this permit are violated, the entire permit may be revoked and the owner may be subject to legal prosecution. 6. Erosion control measures must be implemented prior to any topographical alterations. s.... I ^ GRADE & FILL APPLICATION COUNTY OF OTTER TAIL - LAND & RESOURCE MANAGEMENT 121 W JUNIUS SUITE 130, FERGUS FALLS, MN 56537 218-998-8095 Otter Tail County’s Website: www.co.ottertail.mn.us PERMIT N0._3T13 Application Fee Receipt Number Lixve\rv\-g. FosWv - "Toovv/v \^a,V>JL. U^cxv/^cii' Mn: . 5~^675^_________________ 2)^ _____________ PROPERTY OWNER I M5 . MAILING ADDRESS CITY, STATE, ZIP DAYTIME PHONE NUMBER Uai^ Lstf’ PARCEL NUMBER(S) i / 2^0^ J £hCLASSLAKE NO.LAKE NAME It >4 w^ovTTWP NAMESECTION LEGAL DESCRIPTION 7a>P -^3V /8?yvgc ^2 5£ _______________fk.JJV_ 2?^ E-911 PROPERTY ADDRESS I 'Oi“ SIGIWURE OR PROPERTY OWNER/AGENJ-POR OWNER DATE z DATEL&R Official DESCRIPTION PROJECT REQUEST BELOW (Provide Scale Drawing On Back) / CLK.TOTAL CUBIC YARDS \ V^o^es cx\j\ 3\^o^vy^^ ‘tj^isV'ivA^ so Cv'^cl-^ To b lac/jsL. \ v\o^ KVJ o^v/\c\ Cos>A^ S\Ws. A\ c^>rNO^ (bV-C^045_. C Vi\ bac^N •DVA BK05/00 311,493 • Victor Lundeen Co., Printers • Fergus Fails, MN • 1-800-346-4870 :> - .i.feet, orScale:.grid(s) equals Jnch(es) equals feet Please use this sheet for the required scale drawing of your proposal. Be sure to include lot dimension, water frontage, and setbacks from RW, lake, lot lines, sewage system, top of bluff, existing structures and all irhper- viou Required impervious surface coverage calculation (See definition in Shoreland Management Ordinance) mmm 5. X 100 =% . Total Impervious Surface Onsite (FT2) Total Lot Area (FT2) !I "yiu'i w. To kv>^l rOCkAs I! s> 4 - :::>^n -Signature Dated B \ White - Office Yellow — Owner Pink — Assessor Goldenrod — inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY (^8 0Permit No„LEGAL Date / 0 - i 3, - •> XDESCRIPTION AND LOCATION £D h M f)/^U/ 1 K Lake No.Lake Name Lake Classif.Sec.TWP Range TWP Name IDENTIFICATION; Please Print Ail information Last Name First Initial_____Mailing Address— No. StreeL City and State/ic A ^ ^ (p Zip No.Tel. No. ^ r?AOwner NameContractor Architect Name. TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: (j/T^Nm Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling'sJ /, Urjits Specify:.a 0 > a,'/ ( ) Other ESTIMATED COST OF IMPROVEMENTS 0 0 0 >(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: (LK^JoKKtoonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public (I ) IwrItVidual Septic Tank, etc. WATER SUPPLY: ( ) Public (W^lndividual Well MECHANICAL EQUIPMENT ; Elevator: ( ) Yes Air Conditioning: ( ) Yes _________( ) Central Basement: ( ) Yes Stories above basement: Sq. feet (outside dimension) Bedrooms I Baths...../. HEATING: ( ) Electric ( »^r'Ga% ( ) None Type of Roof; CL 0 P '(*^No ( ) Oil {{yuo ( ) Coal Other:( ) Unit CHARACTERISTICS:'■f/X....Lot Area is square feet.Water frontage is....... feet. (Building Line) feet feet. Building set back from high water mark is Land height above high water mark at building line is Building set back from State highway is........................ Side yard is Building will be located Building will be located...... >I/Ofeet — from road or street is feet. i-Us:1±..and feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). feet. IjOI 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. /J) r._(X - 7 2.Dated. Signature of Owner Permit: Permission is hereby granted to the above named applicant to perform the work described in the above ftatement. This permit is granted upon the 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. S^i^eland Management Offl^af / 0- Q Dated State Surcharge $ ^ ^ S~~ 0 ^ (if (oPermit Fee $.V ■ Comments: Form No. MKL-0771-002 158899 VICTOR umeccD « eo.. patHTtRi. rcn«u« rM.Lt. hihh SHORELAND MAIMAGEMEIMT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY White — Office Yellow — Owner Pink — Assessor Goldenrod —^Inspector df Permit No..LEGAL Date.DESCRIPTION AND LOCATION ZZ23 ~77Ti / /T Lake No.Lake Classif.Lake Name Sec.TWP Range TWP Name IDENTIFICATION: Please Print All Information Last Name InitialFirst Mailing Address— No. Street. City and State Zip No.Tel. No. Owner NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: ( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling Specify:, Units ( ) Other ( ) Other Size ESTIMATED COST OF IMPROVEMENT $(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement: ( ) Yes ( ) No Stories above basement: Sq. feet (outside dimension) Bedrooms Baths HEATING: ( ) Electric ( ) Gas I ) Coal Other: Type of Roof:( ) No ( ) Oil < ) No ( ) None ( ) Unit CHARACTERISTICS: Lot Area is square feet.Water frontage is . feet. (Building Line) ...............................feet feet. Building set back from high water mark is................... Land height above high water mark at building line is Building set back from State highway is........................ Side yard is.................... Building will be located Building will be located feet — from road or street is feet. .......................................feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.). and feet. 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. Dated 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 Permit Fee $.State Surcharge $. Comments; not CALLLi-f rl*- Form No. MKL-0771-002 VICTOD LUHSeiN < CO.. PNlHTEM. rCRSUS FALLS. 1S8899 INSPECTOR'S CHECK LIST Make all measurements and computations MINIMUMShall Be 4. Sq. Ft,ACTUALIS I Sq. Ft.Lot Area (Square feet)Sq. Ft. Ft.Ft.Water Frontage Ft.Building Set Back from High Water Mark Building Set Back from State Highway Ft. 50 Ft.Ft. 40 Ft.Ft.Building Set Back from Street or Road &Ft.&Ft.Side Yard Ft.Ft.Rear Yard 10 Ft.Occupied Building to Septic Tank Ft. 20 Ft.Occupied Building to Absorption System Ft. Elevation at Building Line above High Water Mark_____________3 Ft.Ft. Inspector's Comments: Inspector's Signature Title Inspection Dated 19 Agency ViCTOM UIHOiex « eo . MINTEM*. FC«tU« FM.I.B. MtHN.