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Home My WebLink AboutWhite Oaks Resort_41000020010000_Shoreland Permits_V SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMIT WHITE — Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor )irsr°lPermit No.LEGAL /DESCRIPTION JMW/if l~es pcp T (r C17 X. ' ^ -4> C?ex ex-AND LOCATION S 'T V RANGELAKE NUMBER LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP TWP NAME /5 2-C'SciTTLC-MX" O J>3^^ PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER ^I^6oo~ o-2,-^ (SO I a o o> IDENTIFICATION: Please Print All Information First Initial Mailing Address — No. Street, City and State Telephone No.Last Name Zip Code ?,o So ^ 5 3-Property Owner ry\ rJL.L^ov\La- no Y Pi ./NameContractor#Ltc TYPE OF PROJECT PROPOSED USE ( ) Residential (Non-Residential RESIDENTIAL USE NON-RESIDENTIAL USE { ) Garage ( ) Utility Structure ( ) Water Orientated Accesso^ StructureiLe'w' FtoiacJI—- CHARACTERISTICS ( aJ ) Walkout Basement ( Height of Structure_ New Structure ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling # of Units ( ) Basement(4()fLL( ) Other FI. ( OtherTYPE OF SEWAGE DISPOSAL TYPE OF FRAME ( ) Masonry ( Y/r^Wood ( ) Structural Steel ( ) Other WATER SUPPLY Outside Dimensio of StructureOFFICE USE ONLY ) Bluff Impact Zone ( ) Public ( ) Public (\/) Individual Permit #_ V'^ridividual # Of Bedrooms((J ft Of Bathrooms) Shore Impact Zone( Sensitive Area LOT SIZE AND SETBACKS: Lot Area is square feet. Water frontage is feet. Maximum depth of lot feet. / 00Building set back from ordinary high water level is feet. (String Test) oK3Land height above ordinary high water level at building line is feet. Slope of lot %2^^Building set back from road right-of-way.feet. Lo/aLot line setback is and feet. io'Structure will be located J__feet from septic tank (Sewage System Permit must be obtained before installation). 7-0Structure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation). Agreement: I hereby certify that the informatioh contaihed 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. THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES. 7 -2-7Dated: Signature ol Owner 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 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. 7- Z-T-S 7_Dated: Land & Resource Management Ofiic^ SO-loPermit Fee $.Receipt No.. Comments: Form No. BK — 0292-002 260.770 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota ^r'- -r^ • SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 • FERGUS FALLS, MN 56537 APPLICATION FOR SITE PERMIT VWHITE — Office GOLDENROD — Inspector YELLOW — Owner PINK — Assessor U)\^ire M ^ Te S pLP T t, ^ LEGAL Permit No. DESCRIPTION ^ ■(a 6X 5x-AND LOCATION LAKE NUMBER LAKE/RIVER NAME SECTIONLAKE/RIVER CLASS TWP RANGE TWP NAME 31 AjJ" O A<2o J> PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER M/'-(5o(3“ ogo ! o-c> o o IDENTIFICATION: Please Print All Information Last Name First Mailing Address — No. Street, City and StateInitial Zip Code Telephone No. P.o /So ^Property Owner t>y ivlLr- ira L .Co W bSVTrXNameContractorJx?i TYPE OF PROJECT PROPOSED USE ( ) Residential ( Vf^on-Residential RESIDENTIAL USE NON-RESIDENTIAL USE { X) Garage ( ) Utility Structure ( ) Water Orientated Accessory Structu re CHARACTERISTICS wrf^ew Structure ( 4)(( ) One Family Dwelling { ) Multiple Dwelling # of Units ( ) Basement Walkout Basement ( Height of Structure_ ( ) Alteration ( ) Other ml Ft. 1 ( >^ther ITYPE OF FRAME TYPE OF SEWAGE DISPOSAL WATER SUPPLY Outside Dimension of Structure I36 yS-Q,{) Masonry OFFICE USE ONLY Bluff Impact Zone Shore Impact Zone ( ) Public J( ) Public ( vXindividual Permit #_ vXln"dividual # Of Bedrooms((ood { ft Of Bathrooms( ) Structural Steel ( ) Other { Sensitive Area{ LOT SIZE AND SETBACKS: Lot Area is square feet. Water frontage is feet. Maximum depth of lot feet. /Building set back from ordinary high water level is feet. (String Test) 3Land height above ordinary high water level at building line is Building set back from road right-of-way_____________________ feet. Slope of lot % feet. /aLot line setback is and feet. /o'Structure will be located —feet from septic tank (Sewage System Permit must be obtained before installation). —feet from soil absorption system (Sewage System Permit must be obtained before installation).7c/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 herewith 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. Signature of Owner {/ 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 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. 7 - ^7 'Dated:75^ Land & Resource Management Office 7 - 2.7 - S 7_Dated: Permit Fee $.Receipt No.. Comments: I Form No. BK — 0292-002 260.770 — Victor Lundeen Co.. Printers. Fergus Falls. Minnesota 't ’ INSPECTION RESULTS Make all measurements and computations ACTUAL MINIMUM Sq. Ft. Lot Area (Square feet)Sq. Ft.Sq. Ft. Water Frontage Ft.Ft. Building Set Back from High Water Level Ft.Ft. I>c>Building Set Back from Top of Bluff Ft.30 Ft. Building Set Back from Road Right of Way Ft.20 Ft. Building Set Back from Lot Line Set Back Ft. &Ft.Ft. wBuilding Height Ft. Ft. Building Set Back from Septic Tank Ft.10 Ft /go fBuilding Set Back from Absorption System Ft.20 Ft Elevation AboveHigh Water Level at Building Line Ft.3 Ft. Land Slope at Building Line % Inspector’s Comments:1 Sketch: L‘*hi-I 1 Inspector's Signature Date of Inspection /Lrro Time of inspection SHORELAND MANAGEMENT — COUNTY OF OTTER TAIL COUNTY COUNT HOUSE Phone 218-739-2271 • Fergus Falls, MN 56537 APPLICATION FOR PERMIT TO INSTALL SEWAGE DISPOSAL SYSTEM A'WhftB — Office * Yelbw — In^yector Pink — Owner SzooPermit No.,■ ;LEGAL DE^RIPTION /Jl^av-oZ. -oofp~coo ^ r-^7> 3^ hJ\(\CuO^ AND .'jX £ fei-f-frie P-nLOCATIOVn Lake No.Lake Clasilf.Lake Name Sec.TWP TWP NameRange IDENTIFICATION; Please Print All Information. Mailing Address — No. Street, City and StateInitial Tel. No,Last Name First Zip No. EiorincCA.OWNER V-SEWAGE SYSTEM INSTALLER 12Name. / This System will be ready for inspectiort on., 19 This space for office use only Ml Date Rec'd vi .M Phone Call Rec'd By Owner or Agent SignatureTime Rec'd U-L. NUMBER OF BEDROOMS:ESTIMATED COST: SEWAGE DISPOSAL SYSTEM DATA: SEPTIC TANK SEEPAGE PIT DRAIN FIELD GIs.Sq. Ft.Capacity q. Ft. Ft.eq_Ft.Ft.Distance from nearest well ‘ISISFt.Distance from lake or stream Ft.Ft. Ft.Distance from occupied building Ft.Ft. /a /aDistance from property line Ft.Ft.Ft. Ft.Ft.Distance from bottom to Water Table Ft. AH distances are shortest distance between nearest points RECORD OF TESTS: Inspection was made on ., 19., Time M .By 2Q.- u/PERCOL TEST DATA:Date of First Test 19...;Rate nI:SDate of Second Test Rate 1st Test t..f.First Test + 2nd Test =Rate2nd Test Taken By The undersigned hereby makes application for permit to install or extend Sewage Disposal System herein specified, agreeing to do all such work inAgreement: strict accordance with ordinances of the County of Otter Tail, Minnesota and Minnesota Individual Sewage Disposal Code Minimum Standards set forth by Minn* esota Department of Health. Applicant agrees that plot plan, sketches and specifications submitted herewith and which are approved by Shoreland Management Offi cial shall become a part of the permit. Applicant further agrees that no part of the system shall be covered until it has been inspected and accepted. It shall be the responsibility of the applicant for the permit to notify the County Shoreland Management that the job is ready for inspection. I understand that I have been granted a sevrage system site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tall County. I understand I must contact my township in order to determine whether or not any addi* tional permits are required by the township for my proposed project.J 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 agents, employees and workmen shall conform in all respects to ordinances of Otter Tati County Minnesota. This permit may be revoked at any time upon violation of any said ordinance. NOTE: Permit void if work is not commenced within six <6| months. Issued Date:. {jy 9 3ca^(r\3 ^ HI V ________________________; ooLni^fS 237.443 — VIctof Lundeen Co.. Printers, Fergus Fells. Minnesota anagem Fee $Rec # Comments: Form No. MKL-0320eS 9 t \07I !-2/ INSPECTION RESULTS 6.7 O V 0Inspector must make all measurements\; SEWAGE DISPOSAL SYSTEM STATISTICS \/ 2/ ^ Cl SEPTIC TANK SEEPAGE PIT DRAIN FIELDCATEGORYActualShould Be Actual Should Be Actual Should Be toaoI l^f^p / 3Capacity iionZzi3 1200Qls.GIs SF SF SF S F/SQO Distance from Nearest Well FFFF F F •7rDistance from Lake or Stream F F F F F F I-7dPDistance from Occupied Building F F F FF F //■rf- Distance from Property Line F F F F F F ic IDistance from Bottom to Water Table 3 3F F F F F 1 Inspector^'s Comments: t \ I s A I ;iT ;1 focAc.I PS c. f c^- -Date of Inspection.19 / '<^0Time of Inspection G/(gp^ /«!i Inmc/Of INTERPRETATION OF ABBREVIATIONS GIs > Gallons Jod rif ISF « Square Feel F « Linear Feet MKL ' 0320U • Baektr Aff^m ' /< cA»i^I CAt|hi^|CP«M.^