Full Text
Page 1 of 7 After-the-Fact Permit: $25 plus $1 per $1,000 value, and then total is multiplied by 3 Owner Name Parcel # - - Mailing Address for office use only Permit # City Date Submitted State, Zip 60 Days Day Phone Fee Cell Phone Email Property Address Subdivision Twp Section______ Applicant Same as Owner Applicant Name Address 1 Address 2 City State, Zip Email Day Phone Clay County Planning & Zoning 3510 12th Avenue South, PO Box 280 Moorhead, MN 56561-0280 Tel (218) 299-5005 COST: $25 plus $1 per $1,000 value Building Permit Application Rev 8/2023 ---PAGE BREAK--- Page 2 of 7 A) GENERAL INFORMATION LAND USE Current Proposed Agricultural Commercial Industrial Residental Agricultural Commercial Industrial Residental Number of Structures: Types of Structures: ZONING DISTRICT Agricultural General Agricultural Service Center Highway Commercial Limited Highway Commercial Urban Expansion Tier 1 Urban Expansion Tier 2 ZONING OVERLAY DISTRICT** Floodway Flood Fringe General Floodplain Landing Field Resource Protection - Aggregate Resource Protection - Biological Resource Protection – Wellhead Residential District – Shoreland Special Protection - Shoreland Special Protection – Low Development Please see last page for instructions on locating your zoning district, or call our office for assistance Supplemental Data for Building Permit General Contractor: Phone License Septic Contractor: Phone License B) PROJECT INFORMATION TYPE OF PROJECT PROPOSED USE New Construction Addition Single Family Multiple Family # of Bedrooms Repair Agricultural Public Relocation Roofing Commercial Industrial Foundation Only Bedroom Addition Other (specify): Lot Dimensional Data Current Minimum Requirements a. Area in Sq Feet Acres b. Lot width at building line: c. Lot depth: ---PAGE BREAK--- Page 3 of 7 Structure Location Data Proposed Minimum Requirements d. Lake/Stream setback: e. Road setback: f. Side lot setback: g. Rear yard setback: h. Estimated Structure Elevation: i. Minimum access elevation: Structure Type Sewage Disposal Water Supply Residence Garage Public Public Office Warehouse Drainfield Private Well Deck Storage Holding Tank Not Applicable Ag. Building - Intended Use: Alternative System Other (specify): Not Applicable Grain Bin Bushel Capacity: C) STRUCTURE DATA Project Dimensions a. Length b. Width (ft): c. Basement Area (sq. ft.): d. First Floor Area (sq. ft.): e. Second Floor Area (sq. ft.): f. Total Area (sq. ft.): (c + d + e) Type of Construction Heating Wood / Frame Oil Masonry Gas Metal Electric Pole Building Wood On-site Prefab Solar Off-site Prefab Other (specify): Other (specify): ---PAGE BREAK--- Page 4 of 7 I hereby certify with my signature that all data on my application forms, plans, and specifications are true and correct to the best of my knowledge. Signature of Signature of Township _____APPLICATION IS HEREBY DENIED _____PERMISSION IS HEREBY GRANTED All in accordance with the application, addendum form, plans, specifications, and all other supporting data, unless specified hereinafter in the GENERAL and/or SPECIAL PROVISIONS. BY ORDER OF: Signature of Permitting Authority Title Date NOTE: THIS PERMIT TERMINATES ON: except as provided for by local ordinance and/or Minnesota Law. Certificate Issued: Construction Cost* $ (whole dollars only rounded up to nearest thousand) BUILDING PERMIT: $25 plus $1 per $1000 value of construction cost = FEE (AFTER THE FACT = 3 x total fee) *Construction costs are verified by Assessors Office at time of next property appraisal. Site Drawing Elevation View Plan View Topo Survey Lot Profile Lighting Plan Plumbing Lot Survey Other (specify): ---PAGE BREAK--- Page 5 of 7 ---PAGE BREAK--- Page 6 of 7 SHORELAND & FLOOD PLAIN INFORMATION: If your property is in the shoreland from a lake (1000 ft) or river (300 ft), you must complete the following: Shoreland Management Data Classification: Lake/Stream Lake/Stream I.D. Natural Environment Recreational Development General Development SHORELAND MANAGEMENT / FLOOD CONSTRUCTION DATA Water Level Data (Required only if property is in flood plain) a. Datum: Sea Level Assumed b. Highest known water level: c. Highest known ground water level: d. Ordinary highwater level: e. Base Flood (100 year) Elevation: f. Freeboard / required by ordinance: g. Floodway stage increase: h. Regulatory Flood Protection Elev. (RFPE) (e+f+g) Structure Elevation Requirements In: N.G.V.D. Proposed Required a. Basement (or lowest floor: b. First Floor (above ground): c. Max Building Height: d. Fill Elevation Adjacent to Structure: ---PAGE BREAK--- Page 7 of 7 How to access the zoning map: Go to Select dark gold circle “GIS MAPPING” Scroll down the page to “Online Mapping Applications” and select “Zoning Map” If you have accessed this form online, you may go directly to the zoning map by clicking this link: In the search bar in the upper left, put in the parcel number (xx.xxx.xxxx) and hit enter. Once that has populated, you will go to the second icon on the top right that looks like a stack of papers. Click that icon and at the top you will see Layers. Select "Turn all layers on". Once you have applied all layers (be patient, this can take up to a couple minutes), then select the first icon at the top right which is the Legend. You can match the colors of the layers to the legend to determine what the zones are. Some of the colors are close to each other, so disabling one of the options is the best way to determine which zoning is which color. Note, there may be several layers on one single parcel. To locate and identify all layers on your parcel, deselect the zoning of the first color you see. That will then reveal the next layer or zoning district. If you need assistance with zoning district information, please call our office at [PHONE REDACTED]. ZONING DISTRICT IDENTIFICATION