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Home My WebLink AboutWinter Haven_21000170112001_Shoreland Permits_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 ■X Permit No.PLEASE PRINT OR TYPE ALL INFORMATION RANGELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS SECTION TWP NO.TWP NAME G/jd gc / 7 |/J/- 71 PARCEL NUMBER (S) E-911 ADDRESS ^S-S~qC/JS'QS'^000 / 70//Z-00 / LEGAL DESCRIPTION Daytime Phone No.Mailing AddressLast Name First Initial /9C_________So^C'^/G-Property Owner y 9Uf_Contractor Lie.# PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling ( 4 ) MHA'R____ ( 7 ) Add’n To Non-Dwelling J^^torage Structure (10 (Other. ONSITE WATER SUPPLY ^^ublic ( ) None NOTE: MN Rules Chpt. 4725 (MN Well Code) requires a 3’ (minimum) structure setback to a well. ONSITE SEWAGE TREATMENT SYSTEM ^Permit No ( ) OTLSD * Jmp^tnY'Wfr ( 2 ) Add'n to Dwelling ( 5 ) RCU/Year_____ ( 3 ) 'Replacement Dwelling ( 6 ) Detached Garage (9) WOAS individual raffd after verification from the O.T.LS.D. that a conforming sewage sptem wiil be instailed to service this lot contact Rottie Mann at 864-5533.'Existing Dweiling to be removed before. CHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS OF PROPOSED NON-DWELLING Outside Dimension pt. x Setback to Lotline Ft. & 7- p( Setback to Right of Way 2jUgA Pt." Setback to OHWl/c^P^ Pt. Elevation Above OHWL ^7*' Ft. Setback to Septic Tank /OT^ Ft. Setback to Drainfield /O ^ Ft. Setback to Bluff________ ^ Maximum Proposed Height Bathroom Proposed ( ) Yes No CHARACTERISTICS OF PROPOSED WOAS 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 X Maximum Propo^ Height Basement / Walkout ^ement Total Bedrooms_ OutsideDim^on Setback plotline ___ Setback to Ri^lt(of Way Setback to OHWl\, Ft. X Ft."Ft."Ft. X Ft." Ft.&Ft."Ft."Ft.& Ftr*Ft." Ft.Ft.Ft. Elevation Above OHWU Setback to Septic Tank. Setback to Drainfield _ Ft.Ft. Ft.Ft. Ft.•t. Ft.Ft.Setback to Bluff Ft. Yes No Maximum Proposed Height ( ) Boathouse ( ) Gazebo Yes No ( ) Screen Porch N ( ) Storage Structure ProiectA-otlines/RIght-of-ways Must be Staked OnsitieI'll* **Pr6|ect/Lotlines/Right-of-ways *^Must be StaJkeiLOnsite Spoil Disposal □ Onsite (scale drawing required) (^Offsite □ Within Shoreland Area □ Outside Shoreland Area CHARACTERISTICS OF LOT; Grade/Fill/Excavation □ Yes (scale drawing required)/ C^aO'f'.Yes i^^C^No,Sq. Ft.Bluff Onsite.Lot Area Water Frontage Ft. ■7S-5'7 / ZJ-,7R~U Total Lot Area (Ff!) '. oc-z^Impervious Surface Ratio:xioo =.%Total Impervious Surface Onsite (FT^)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 responsibiiity to inform the Land & Resource Management office once the building footings have been constructed. fAzAz 'Signature of Property Owns/f Date: r SDate: Resource Management OfficeLand & PERMIT FEE $RECEIPT NO. C 7^C/S~ 5/Tyt p £^7-7.0 ______________________ Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application.Comments: A Form No. BK — 0500-0201 304,202 • Victor Lundeen Co.. Printers • Fergus Falls. 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 v /;PLEASE PRINT OR TYPE ALL INFORMATION Permit No, SECTION TWP NO.RANGELAKE / RIVER NO.LAKE/RIVER NAME LAKE/RIVER CLASS TWP NAME 7 / //eo5 6 “77 c !<L /">7 U/V-U/ PARCEL NUMBER (S)E-911 ADDRESS j —/ Oou / 7 0// g- Oo /•• LEGAL DESCRIPTION 1C A j Last Name First Initial Mailing Address Daytime Phone No. i5- ^ 0 ^ C-c /Q,Property Owner ■1 \ 7^j■! 's9,U fContractor Lie.;] -•PROPOSED PROJECT (please circle the appropriate number) (1 ) New Dwelling ( 4 ) MHA'R_____ (7) Add’n To Non-Dwelling pf‘)-Storage Structure (10) Other. 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(2 ) Add’n to Dwelling ( 5 ) RCU/Year______ (3 ) 'Replacement Dwelling ( 6 ) Detached Garage (9) WOAS 7----------— /•(>t) Permit No. ^ ( ) OTLSD * This permit is only valid after veriScation from the O.T.LS.D. that a corthrming sewage system will be Installed to service this lot contact Rollie Mann at 864-5533.'Existing Dwelling to be removed before. 1CHARACTERISTICS OF PROPOSED DWELLING CHARACTERISTICS OF PROPOSED NON-DWELUNG Outside Dimension Ft. x Setbaok to Lotline Ft. & y u v pj». Setback to Right of Way pt.** p, Elevation Above OHWL ^ Ft. Setback to Septic Tank /QT' pt. Setback to Drainfield ^ O ^ Ft. Setback to Bluff Maximum Proposed Height Bathroom Proposed ( ) Yes (Xf No CHARACTERISTICS OF PROPOSED WOAS 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 Propr^d Height Basement Walkout Basement Total Bedrooms__ Outside Dimension Setback to.Lotline ___ Setback to Righ] of Way Setback to OHWL Elevation Above OHWL'. ^ Setback to Septic Tank \ Ft. Setback to Drainfield____ Setback to Bluff________ Maximum Proposed Height ( ) Boathouse ( ) Screen Porch ' ( ) Storage Structure 5 yFt."Ft. X Ft."Ft. X Ft." Ft.&Ft."Ft.&Ft." Ft." Ft..';/Setback to OHWL ■Ft. 7 Ft. Ft.Ft. z Ft. Ft.■X. Ft.Ft.Ft. /WxYesNo Yes No ( ) Gazebo **Project/Lotlines/Right-of-ways Must be Staked Onsite Spoil Disposal □ Onsite (scale drawing required) Q Offsite □ Within Shoreland Area □ Outside Shoreland Area Grade/Fill/Excavation **Project/Lotlines/Right-of-ways Must be Staked Onsite□ Yes (scale drawing required) CHARACTERISTICS OF LOT; Lot Area ' J>5 '/ So. Ft.- r6>oo Z NoWater Frontage .Ft.Bluff Onsite____Yes 76-y 7 6, 2:/ (c^Impervious Surface Ratio:X100 =.% Total Impervious Surface Onsite (FT^)Total Lot Area (FT^)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 & Resource Management office once the buiiding footings have been constructed. //u ■- 7-Date: Signature of Property Owner,x.:^ t fn/ofDate: Land & Resource Management Officeo 0 / 77^-eo77—PERMIT FEE $RECEIPT NO. Project/Lotlines/Right-of-Way MUST be Staked Onsite Prior to Submission of Application.6/7c ^ 7"Comments: . 9 L 7 7-V4 c 7 J' /_L r ■ -'9 .L Form No. BK — 0500<0201 304.202 • Victor Lundeen Co., Printers • Fergus Falls, MN • 1-800-346-4870 (r ■ ■SITE PERMIT INSPECTION RESULTS Inspector must make all measurements and computations ;Structure Set Back from Ordinary High Water Level Ft.Ft. J l<rStructure Set Back from Top of Bluff Ft.Ft. Structure Set Back from Road Right of Way /o'O Ft. Ft. /Structure Set Back from Lot Lines Ft. &Ft.Ft.&Ft. IStructure Height Ft.Ft.<^10 Structure Set Back from Septic Tank I Ft.Ft. Structure Set Back from Drainfield Ft.Ft. Elevation Of Lowest Floor Above Ordinary High Water Level AS Ft.Ft. Land Slope at Building Site %% c9Vo VInspector’s Comments / Sketch: j t. loA (4 \A ^ / Mo fSc/, Inspector's Signature Date of Inspection Time of Inspection atPmject Approved Date/Initial ' ; / "= Jo' ScAt-^ COo> Oi CO CABIN i /.- n i /j K/-CABIN \ DOUBLECABIN■V SMiZ. GARAGE CABIN r STORAGE driveway SHEDI2I____ PROPANE TANK SEKR CLEAN OUT- o J / ORESffl\ MORE OR LESSWELL /j»f 4a4^ Z,*fA*AUL^ /I. ry\j- \HOUSE\ \\ \I V I(^/^^Yeoiou s\ \ViTO\ \Y0/.6Y-\\«>/Cj ^\ /O / Jo\ \/S“>- /6 p/to __V /O(M/-~ffC - ft/to\C/1/e ^'>30\\?6\672.\ OUT HOUSE METES tSc BOUNDS TRACT r White — Office Yellow — Owner Pink.— Assessor Gold«nrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone: (218) 739-2271 - Fergus Falls, Minnesota 56537 APPLICATION FOR SITE PERMIT* Permit No~Qy.L-0LEGAL By( Trs ■ DESCRIPTION AND C c' n (pT i /t yLOCATION ^ 5* ( ~^5 • e f 4 tw3a5 NameLake No.Lake Classif.Sec.TWP RangeLake Name IPENTtFICATION: Please Print All information Last Name Mailing Address— No. Street. City and State Zip No.Tel. No.First Initial Ro ^ n s 11| A V c-AH uOwner NameContractor Architect Name, TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: d, A& IO( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling ( ^t'other Specify:, Units w ( ) Other Size ESTIMATED COST OF IMPROVEMENTjS PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: / Ct() Maebnry Wood Frame ( I Structural Steel ( ) Other — Specify ( ) Public ( I Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( ) Individual Well Basement: (VI Yes ( I No Stories above basement: ....... Sq. feet (outside dimension) .... Bedrooms / Baths...(. Type of Roof; LX' CHARACTERISTI Lot Area is’'^l.f;square feet.Water frontage is feet.Maximum depth of lot 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 right of way.... Side yard is Structure will be located feet. (Building Line) 3 feet SO feet — from road right of way is .feet. /o and feet. /o ,feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).'2^0Structure 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 se forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted herewit shall become a part of this permit application. I also understand that this permit is valid for a period of six (6) months. ,1THIS IS A SITE PERMIT ONLY AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16. MINNESOTA STATE STATUES. V re of Owo6r —V-W*- Signjaltijr 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 workrnen 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. Permit: ■7-:2 G 'Dated Shoreland Management Official I So /Permit Fee $. Comments: 195676@ VICTOR lundcen co.. printers, pbrous pall*, minn.Form No. MKL-0771-002i <. * ' 'White - Office Yellow — Owner ^ Pink Assessor Goldenrod — Inspector SHORELAND MANAGEMEIMT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone; (218) 739-2271 — Fergus Falls, Minnesota 56537__ APPLICATION FOR SITE PERMIT J0-rs-<o.\ Permit No..G,.LhLEGAL DESCRIPTION AND pl^ F^orO.<^C c/ n Zi I I n ^LOCATION MnLake Classif. d / 4 ' n P' 0 A/ ■'^'6 ■nSec.TVW NameTWPRangeLake No. Lake Name IDENTIFICATION: Please Print All Information Tel. No.First Mailing Address— No. Street. City and State Zip No.Last Name Initial w / / t"AKO - ^ iOwner mr'J1 NameContractor Architect Name. TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE: t/( ) New Building ( ) Alteration ( ) One Family Dwelling ( ) Multiple Dwelling ( Other Specify:.5^0 VCr O Units ( ) Other Size ESTIMATED COST OF IMPROVEMENt[$ PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: (Vf^YOT ( ) No( ) Masonry (v-f Wood Frame ( ) Structural Steel I ) Other — Specify ( ) Public ( ) Individual Septic Tank, etc. WATER SUPPLY: ( ) Public I ) Individual Well Basement: Stories above basement: Sq. feet (outside dirpension) Bedrooms d / /Baths Type of Roof: LJ-> CHARACTERISTIC^!^ Lot Area is«..V.square feet. Water frontage is Building 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 feet.Maximum depth of lot feet. ^ /0£>feet. (Building Line) feet S.O.feet — from road right of way is feet. /o/o feet.and 1C?Structure will be located .feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Drainfield, etc.).0^0Structure 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 forth and according to the provisions of the ordinances of Otter Tail County, Minnesota. I further agree that any plans and specifications submitted here' 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 STATUES.fSignature of Owner Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted uponPermit: 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 ' County, Minnesota. This permit may be revoked at any time upon violation of said ordinances. 7- -2 G)- ?Dated Shoreland Management Official I Sc IPermit Fee $. Comments: 195676®VICTOR HjNDEEN CO.. PHiNTKfS. r-rr^^US F A . t S. MINN.Form No. MKL-0771-002 t INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS 1 MINIMUM Shall Be X Sq. Ft Lot Area (Square feet)Sq. Ft Sq. Ft Water Frontage Ft.Ft. \OCiBuilding Set Back from High Water Mark Ft.Ft. Building Set Back from State Highway Ft.50 Ft. 1)0Building Set Back from Street or Road Ft.40 Ft. /Cy & ! O Ft.Side Yard &Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank Ft.10 Ft. Occupied Building to Absorption System Ft.20 Ft. Elevation at Building Line above High Water Mark_____________y Ft.3 Ft. Inspector's Comments: Inspectors Signature Title Inspection Dated 19 Agency VICTOR CVHOEEN 4 CO.. RRlHTIRO. FE«8l.>a FACLO. r 7'r ■i :i1ty|.|e; Vj:mc'll I^.rf ,T,i (jLy<y/. ^ ^//y{ ^JeuJj^^('oJ'\^^ K(a)'■y -pfI»>l«u/;rt/ /:r //■ / _______'/“1 I(A/ ^\/ -9U'/Vi ' t \ Wu. 0^!^I 7^ i- 'fY^i iv x-^'sr-VKs' N\\\\ J\ V,-9 X. ioW J 111111 ■ 1111111 ■ 1111111111111111,, j