HomeMy WebLinkAboutBladow Beach_53000230138000_Shoreland Permits_APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone:(218)739-2271 • FERGUS FALLS, MN 56537
WHITE -
GOLDENROD - Inspector
YELLOW - Owner
PINK - Assessor
^ ucl,
/ 0-f
3 ^ y
Permit No.LEGAL
DESCRIPTION
a.r-
BLUFF ZONEAND
□ YES
■^NO
LOCATION
TWPNO.RANGE TWP NAMESECTIONLAKE/RIVER
CLASSLAKE/RIVER NAMELAKE NUMBER L.o^LjuR usil Lmjc.I3.S 3^GO
FIRE NUMBERTOPOGRAPHICAL ALTERATION
□ YES # OF CUBIC YARDS
NO_______________________
PARCEL NUMBER (S)
S3-6)(90 ^^3 - <s>lS^ ^dCO
IDENTIFICATION: Please Print All Information TELEPHONE NO.
(Daytime)Mailing Address — No. Street, City, State, and Zip CodeInitialFirstLast Name
RR I BerpcProperty
Owner -S o, CyV. cCj I i
6Hi-^r-h^R , S^S7/
^n^J3 PO Boy^ 392/Contractor
^-3h£,nl)£^Le-h 1^State Lie.#7S 7
ONSITE SEWAGE
TREATMENT SYSTEM
jj0' Individual Permit #____
( ) Collector Permit #_____
( )OTLSD
ONSITE WATER SUPPLYPROPOSED USEPROPOSED PROJECT
( ) New Structure(s)
(X Addition(s) _
>' Ml (R'-____________
()<) Dwelling^ Individual
[/) Public
( ) None
( ) Non-Dweliing
( ) Water Oriented Accessory Structure (WOAS)YEAR
CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING
( ) Garage ( ) Utility Structure
CHARACTERISTICS OF DWELLING
( ) Dweiling
^ Addition to Dwelling
( ) Basement
( ) Walkout Basement
Outside
Dimension
t Screen Porch( ) Boathouse
( ) Utility Structure( ) Gazebo( ) Other
Outside
Dimension ( ) Other.
Outside
Dimension
Ft. X
^t.x Ft.
Ft. & 3^ Ft.
.Ft.Lotline Setba«s .Ft..Ft. X i.
Lotline Setbacks._.Ft.OHWL Setback .Ft.&.Ft.Lotline Setbacks2£..Ft.OHWL^ack )Yes NoBathroom:
.Ft.OHWL SetbacIYes / a complying Sewage system Required)Total Bedrooms
Maximum Height / 30 Ft. (2 story)Maximum Height /10 ft. (1 story)Maximum Height /18 Ft. (1 story)
.Sq. Ft. Impervious Surface Sq. Ft. Impervious Surface Ratio .%Lot Area
.Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage
.%__________Ft. Slope of lot
.Ft. (lO’minimum) (Sewage System Permit required before installation).
Ft. (20’minimum) (Sewage System Permit required before installation).
.Ft. (lO’minimum) (Sewage System Permit required before installation).
Structure setback to right-of-way
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 & Resour^ Management office once the building footings have been constructed.
^Sn.no
€.Dated:
Signature of Owner
Dated:
Land & Resource Management Office
RECEIPT NO.PERMIT FEE $
^ cJ-' ~ho R 00. ^
R (LU. / s tt/t Due,c/,._____/y?/nJs-o L
t/e^S't- b3cm lA.Comments:rjix^
'j'QjL. rx.»nrot^^Y'auixj My O'T'(L.O
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a PTC
Fohn No. BK — 0496-002 281.017 ■ Victor Lundaen Co.. Primers • Fergus Falls. MN • 1-800-346-4870
T*
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE, Phone:(218)739-2271 • FERGUS FALLS, MN 56537 fi e^cL</ 10
WHITE - Office
GOLDENROD ■’inspector
YELLOW-Owner
PINK - Assessor^
Permit No.ryi€ ^
/ 0'(’
3 ^ y
LEGAL
DESCRIPTION
^ r
BLUFF ZONEAND
□ YES
^NOLOCATION
i.
TWP NAMESECTIONTWP NO.RANGELAKE/RIVER
CLASSLAKE/RIVER NAMELAKE NUMBER
/vU sll !2>S^36-0V - /V/
FIRE NUMBERTOPOGRAPHICAL ALTERATION
□ YES # OF CUBIC YARDS
NO____________________
PARCEL NUMBER (S)
SZ-OOO - 060
TELEPHONE NO.IDENTIFICATION: Please Print All Information
(Daytime)Mailing Address — No. Street, City, Stale, and Zip CodeInitialFirstLast Name 1ffKa^ I VOXProperty
Owner k I'j I 1-3 0.
M 6UAuX- O-L'-A 5'7/L
r Name <? g, j3 m,/PO Be 3 yj
Contractor ^ty\4 ■( r( Lo -/ t ^pLt PI ,^6 yppAJA/State Lie. #
PROPOSED USE
( ) Dwelling
( ) Non-Dwelling
( ) Water Oriented Accessory Structure (WOAS)
ONSITE SEWAGE
TREATMENT SYSTEM
Individual Permit #_____
( ) Collector Permit #_____
( )OTLSD
ONSITE WATER SUPPLY
{') Individual
(/) Public
( ) None
PROPOSED PROJECT
( ) New Structure(s)
(Xl Addition(s)
)MiyRV____ _____
/
-j
1YEAR
CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING
( ) Garage ( ) Utility Structure
CHARACTERISTICS OF DWELLING
ii.Screen Porch( ) Boathouse( ) Dweiiing
t<j Addition to Dwelling
( ) Basement
( ) Walkout Basement
Outside
Dimension
( ) Gazebo ( ) Utility Structure( ) Other
Outside
Dimension
■
I \( )Other,
Outside
Dimension
.Ft.x .Ft.
! B'y Ft. X i^O Ft.
P _pt.&:■ So. Ft.
.Ft.Ft.&Lotline Setbacks __Ft.
Lotline Setbacks./.Ft.OHWL Setback Lotline Setbacks X Ft.&;.Ft.
75".Ft.OHWL Setback Bathroom: ( ) Yes ) No
(If Yes / a complying Sewage System Required)_Ft.OHWL Setback.Total Bedrooms
Maximum Height / 30 Ft. (2 story)Maximum Height /10 ft. (1 story)Maximum Height / 18 Ft. (1 story)
,Sq. Ft. Impervious Surface Ratio
________________
.%.Sq. Ft. Impervious SurfaceLot Area 75^
Ft. (3’minimum).Ft. Elevation of lowest floor above OHWL
(A( )____________________________
Water Frontage
Structure setback to right-of-way..%.Ft. Slope of lot
.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
C
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 tirne 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.
fA/^ ,
Dated:
&gnature of Owner
A-50 no
0Dated:
LMfKi & Resource Management Offiics
PERMIT FEE $RECEIPT NO.
Vq CUtA S 4 fc t'c Pof f rv\Comments: -5 .: f c*T oA 0 U£ c(./V/ .r/ ri./’ierV /< c u / J .'T c.PjL f ? \// p vf
J L '//. O-'A.BypC-o /y.'Cf r- f p (. pyy r /■y/7
Form No. BK — 0496-002 281.017 • Victor Luodoon Co., rrintors • Forgut Fells, MN • 1-800-348-4 870
-c^.-V <»’
INSPECTION RESULTS
Make all measurements and computations
3^ -f Ft.Ft.Structure Set Back from Ordinary High Water Level
Ft.Structure set Back from Top of Bluff Ft.
Ft.Ft.Structure Set Back from Road Right of Way
S04- Ft. & CSC3/’ Ft.Ft.Ft.&Structure set Back from Lot Lines
y«D Ft.Ft.Structure Height L
Ft.Structure Set Back from Septic Tank Ft.
Ft.Structure Set Back from Absorption System Ft.
Elevation Of Lowest Floor Above Ordinary
High Water Level____________________Ft.Ft.
%%Land Slope at Building Line
Inspector’s Comments / Sketch:,
>0'
:A
I
f —
Inspector 's Signature
Date of Inspection
l 3^J
Time of Inspection
■ jSt»* ••
I
>:i OTTER TAIL COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
COURTHOUSE
FERGUS FALLS, MINNESOTA 56537
MOBILE HOME PARK AND/OR RECRE^IONAL CAMPING AREA INSPECTION REPORT
Lie. No. Posted.Z2M^fs-Dated.Park or CampName
■ Co.
Licensee . _
No. Ind! R.C. Sites
No. M.H. SITES _
a. Location __
b. Caretaker _
Spacing
d. Animals____
e. Water Supply
- . f. Plumbing __
MHD187
; PARAGRAPH:__
_p.o./24 _ Location
s Address
^(y:>j:^<0 No. Dep. R.C. Sites No. OccupiedNo. Occupied
No Occupied _
g. Sewage Disposal _
h. Toilet, Bathing and
Laundry Facilities
i. Incinerators_______
j. Garbage and Refuse
(y^ Vermin Control ___
l. Night Lighting____
m. Community Kitchen
n. Bottled Gas______
o. Fuel Oil Systems__
p. Fire Protection __
Other __________
A^>ue~.— ---
^ y t/ 9 \
!7c? ^
^^
/o'cte^/e—
a - ^c/ ^
Ll\
f'
'' ''V C^^nrx^ ^ ^ L/
____(Lcs.^.
/o'
JL.4
/\X-«
^ J 7 y ^\-
j‘'yn"-7LTr7i''^1^^/ '> oL-J'3 ^
____________________ (PL^
Ja^ ir y^/C^/7
7/^ —- ^
yicz-
,/y TT'
//-U s I,r
cy
A?
Office and Phone No. — ~~7 ^
7=r
Inspector Received By^
OTCDPH
NELSON BROS PRINTING. INC.. Fergus Falls. MN 56537
OTTER TAIL COUNTY
DEPARTMENT OF PUBLIC HEALTH
SUB OFFICE
222 2nd AVENUE S.E.
PERHAM, MINNESOTA 56573
218-346-3175
MAIN OFFICE
OHER TAIL COUNTY COURTHOUSE
FERGUS FALLS, MINNESOTA 56537
218-739-2271
April 4, 1995
Mr. Tim Sucher
Route 1, Box 462
Ottertail, MN.56571
Dear Mr. Sucher:
Please provide additional details on R.V. lot lines, sizes and
separation between Mr. Finch; RV and existing deck and lot line
to RV lot/space to immediate south, and how deck is to be
constructed (all dimensions). Re-submit request with the more
detailed drawing and measurements.
Thank you.
Sincerely,
Mark Ronning, R.S.
Consultant to Otter Tail County Public Health Dept.
;
Otter Tail County Land & Resource Dept.cc;
Mr. Roger K. Finch
2602 N. 3rd Street
Fargo, North Dakota 58102
MR/dc
Printed on RecycJed Paper.
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE
Phone:(218)739-2271 • FERGUS FALLS, MN 56537
WHITE-Office
GOLDENROD • Inspector
YELLOW - Owner
PINK - Assessor
Permit No. '/-5
U~l~ I orf C-L
(<r>n /»-f- _________
LEGAL
DESCRIPTION
BLUFF ZONEAND□ YESLOCATION
RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER
CLASSLAKE/RIVER NAMEUKE NUMBER Q.OS:>0
FIRE NUMBERTOPOGRAPHICAL ALTERATION
□ YES # OF CUBIC YARDS
X'no_____________
PARCEL NUMBER (S)
5' ooo ' ooc /c£
TELEPHONE NO.IDENTIFICATION: Please Print All Information
Mailing Address — No. Street, City, State, and Zip Code (Daytima)InitialFirstLast Name
Property
Owner R9. f i3>£^
S' 7 /
A)eiu l^/J^73f-*^/0^S liiuNameContractor
'^tPKJTcrYl
It i
ONSITE WATER SUPPLY
State Lie. #
ONSITE SEWAGE
TREATMENT SYSTEM
^(flndividual Permit #
( ) Collector Permit #_
( )OTLSD
PROPOSED USE
.^^^welling
^^on-Dwelllng
( ) Water Oriented Accessory Structure (WOAS)
PROPOSED PROJECT
( ) New Structure(s)
^^)^ddition(s)
( )MH/RV____________
^!^lndividual
( ) Public
( ) None
£sc/
YEAR
CHARACTERISTICS OF WOAS
( ) Boathouse ( ) Screen Porch
CHARACTERISTICS OF NON-DWELLING
( ) Garage ( ) Utility Structure
CHARACTERISTICS OF DWELLING
( ) Dwelling
^-Addition to Dwelling ^
( ) Basement
( ) Walkout Basement
Outside
Dimension
^ JLcU ( ) utility structure( ) Gazebo( ) Other
Outside
Dimension/;2.
^ Ft.x 3JL /?<LU f,
^ Ft. & 5*0 Ft.
( ) Other.
Outside
Dimension
Ft.x .Ft.
Ft.&.Ft.Lotline Setbacks .Ft.
Lotline Setbacks .Ft.OHWL Setback .Ft.Lotline Setbi .Ft.&
.Ft.OHWL Setback Bathroorn/^ ( )Yes ( )No
/ (If Yes / a complying Sewage System Required).Ft.OHWL^etback.9Total Bedrooms
Maximum Height / 30 Ft. (2 story)Maximum Height /10 ft. (1 story)Maximum Height /18 Ft. (1 story)
Impervious Surface Ratio .%.Sq. Ft.Sq. Ft. Impervious SurfaceLot Area
.Ft. (3’ minimum).Ft. Elevation of lowest floor attove OHWLWater Frontage
__________Ft. Slope of lot
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 right-of-way.
/oStructure 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 responsibiiity to inform the Land & Resource Management office once the buiiding footings have been constructed.
Dated:
Signature of Owner
Dated:
Land S Resource Management Office
50 —RECEIPT NO.PERMIT FEE $
4~o ^tU. Srf=>
Comments:
V
^ /^CCL
/HUS
Form No. BK — 0496-002 281.017 ■ Victor Lundeen Co. Printers ♦ Fergus Fells. MN • 1-600-346-4870
---
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENTOTTER TAIL COUNTY COURT HOUSE
Phone:(218)739-2271 • FERGUS FALLS, MN 56537
WHi:
GOLDENROD - Inspector
YELLOW - Owner
PINK - Assessor
IMSir
Permit
5J> / erf 3 i
(a>^ I o-t _________
tLEGAL /“I
DESCRIPTION
BLUFF ZONEAND□ YESLOCATION
SECTION TWPNO.RANGE TWP NAMELAKE/RIVER
CLASSLAKE/RIVER NAMELAKE NUMBER
3g- m I
TOPOGRAPHICAL ALTERATION
□ YES # OF CUBIC YARDS
.aCNo____________
FIRE NUMBERPARCEL NUMBER (S)
S3-000'33-c-/ooc /C8
IDENTIFICATION; Please Print All Information TELEPHONE NO.
(Daytime)Mailing Address — No. Street, City, State, and Zip CodeFirstInitialLast Name
'T:l^Property
Owner ^ f< I l3c-yL V X
<S^€f4o,',l HYlKf Sc f
<AJtlL 73 f-5 ULr\>^aJ nName OContractor
4^State Lie. *i_L
ONSITE SEWAGE
TREATMENT SYSTEM
^ Individual Permit #
( ) Collector Permit #.
( )OTLSD
ONSITE WATER SUPPLY
.^^Individual
( ) Public
( ) None
PROPOSED USE
.^^Dwelling
^TNon-Dwelling
( ) Water Oriented Accessory Structure
(WOAS)
PROPOSED PROJECT
( ) New Structure(s)
^^T^ddition(s)
( )MH/RV____________
£S>0
YEAR
CHARACTERISTICS OF WOASCHARACTERISTICS OF NON-DWELLING
( ) Garage ( ) Utility Structure
CHARACTERISTICS OF DWELLING
( ) Screen Porch( ) Boathouse( ) Dwelling
(^Addition to Dwelling ^
( ) Basement
( ) Walkout Basement
Outside
Dimension
y ( ) utility Structure( ) Gazebo( ) Other
Outside
Dimension/X
^ Ft.x 3X A'lLUpt
50 Ft.
( )Other.
Outside
Dimension
.Ft.x .Ft.
r Lotline Setbacks Ft.&.Ft..Ft.
SO .Ft.&Lotline Setbacks OHWL Setback .Ft..Ft.Lotline Setbar .FI.&7S .Ft.OHWL Setback Bathroonm/'^ ( )Yes ( )No
/ (If Yes / a complying Sewage System Required).FtOHWL^etback
Total Bedrooms
Maximum Height /10 ft. (1 story)Maximum Height / 30 Ft. (2 story)Maximum Height /18 Ft. (1 story)
S’ Acr-cS .%Sq. Ft. Impervious Surface Ratio.Sq. Ft. Impervious SurfaceLot Area
^ <3^ // ..Ft. (3’ minimum).Ft. Elevation of lowest floor above OHWLWater Frontage
9^0 %' ______Ft. Slope of lot
.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 right-of-way.
JOstructure setback to septic tank
94jDwelling 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 responsibiiity to inform the Land & Resource Management office once the building footings have been constructed.
/
Dated:
Signature of Owner
Dated:
Land & Resource Management Officeso°-PERMIT FEE $RECEIPT NO.
4^Jo C .yTUg-tn
C- c c,<
Comments:
i7-
r/v 7rc ,7^
n,/-( S f r7 J'O
yS<y<ULyky4‘4- r 7 i' ■'' r\ Ir 7 (''?' U^ n
•/.y /'y /f- >'V , r
y /7 ct. .Form No. BK — 0496-002 281.017 • Victor LundMn Co.. Printeri • Fergus Fsils. MN • 1-800-348-4870
N.
INSPECTION RESULTS
Make all measurements and computations
Ft.Structure Set Back from Ordinary High Water Level Ft.
Ft.Ft.Structure set Back from Top of Bluff
/ (TO -f-
5^ r
Ft. Ft.Structure Set Back from Road Right of Way
Ft.&Ft.Ft.Structure set Back from Lot Lines
/ 0 Ft.Ft.Structure Height
Ft.Structure Set Back from Septic Tank Ft.
Ft.Structure Set Back from Absorption System Ft.
Elevation Of Lowest Floor Above Ordinary
High Water Level____________________Ft.Ft.
%%Land Slope at Building Line
;
Inspector’s Comments / Sketch:,
O 7 ^
/y4~
Inspector's Signature
li'
Date of Inspection
Time of Inspection
X ■■■
I GRID PLOT PUN feet SKETCHING FORM.grid(s) equals _j^L_feet, orScale:inch(es) equals
Dated; Vf \ <2 "^1 CiL-^yuL.19
u Signature
Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently
on lot and any proposed structures.
I
o
Lot
MKL —0871 —029 27B,^^ • Victor Lurtdeen Co.. Printers • Fergus Falls. MN • 1 •800-346-4070
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
, WHiTE — Office
GOLDENROD — Inspector
YELLOW — Owner
PINK — Assessor
^|oOK- J_l HJL-t
Permit No.LEGAL
DESCRIPTION
AND
LOCATION
RANGESECTIONTWP NO.TWP NAMELAKE/RIVER NAME LAKE/RIVER
CLASSLAKE NUMBER
Si,-l>ll LeKC.37C>D I3>S
FIRE OR LAKE ASSOCIATION NUMBE
U -y
PARCEL NUMBER (S)
/o8 7(^-6bC) -^3- Ol2)Z' OOO
IDENTIFICATION; Please Print All Information
Mailing Address — No. Street, City and State Zip Code Telephone No.First InitialLast Name
9T) 'O
^7^. /a irProperty
Owner r &OQ 7
]^o(o£/Z.aJ. snp srNameContractor
1 332^8State Lie. #
CHARACTERISTICS OF PROPOSEDNON-RESIDENTIAL USE
( ) Garage
( ) Utility Structure
) Water Orientated
Accessory Structure5C/^fc2Vt^C:^
( X ) other
lOPOSED USE
) Residential
) Non-Residential
RESIDENTIAL USEPROPOSED PROJECT
Basement ( )
Walkout Basement ( )
Outside Dimerisipn{, ,
of Structure ^ A ^ t
Height of Structure £
ft Of Stories_____I______
( ) One Family Dwelling
( ) Multiple Dwelling
# of Units ( )
( ) New Structure
( ) Addition
{ y^) MH/RV
(
/W5 /(Ft.YEAR
ONSITE SEWAGE
DISPOSAL SYSTEM
ONSITE WATER SUPPLYTYPE OF FRAME
( ) Masonry
( ) Wood
( ) Structural Steel
( ) Other
Ft.
( ) Public
(;?o
OFFICE USE ONLY
) Bluff Impact Zone
) Shore Impact Zone
) Sensitive Area
^4( ) Public RVf2£!^A\
()C) lndividual^^<^cm Permit #_72£__
( ) OTLSD
{# Of BedroomsIndividual
fi.V(# Of Bathrooms) None
(
LOT SIZE AND SETBACKS:
feet. Maximum depth of lot feet._o^^uQ^e feel. Water frontage isLot Area is_
feet. (String Test)Building set back from ordinary high water level Is
3 feet. Slope of lot %Land height above ordinary high water level at building line is
feet.Building set back from road right-of-way
30 50 feet.Lot line setback is and
[Q_Structure will be located feet from septic tank (Sewage System Permit must be obtained before installation).
Structure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation).
THIS IS A SITE PERMIT ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 1 ft MINNESOTA STA TE STA TUTES.
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 accord
ing 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
(I understand that it is my responsibility to inform the Land £r Resource Management office oj :e the building footings have been constructed.)
3//^/Dated:
Signature ot 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.
i3.^jtihs
5,0, 00
Dated:
Land & Resource Management Office
Permit Fee $.Receipt No.
7 ^ • I
Comments:
f »
lC,U ,'yrvJuaT
Form No. BK — 0292-002 270.500 ■ Victor Lundeen Co Printers • Fergus Falls. MN • 1-800-346-4870
V—
/
«APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
1WHITE — Office
GOLDENROD — Inspector
YELLOW — Owner
PINK — Assessor
^oDK-
Permit No.LEGAL
DESCRIPTION
AND
LOCATION
SECTIONLAKE NUMBER LAKE/RIVER NAME LAKE/RIVER
CLASS TWP NO.RANGE TWP NAME
Sfc- /'//LeKC.37Q>0 !3>S
PARCEL NUMBER (S)FIRE OR LAKE ASSOCIATION NUMBER ,
/OB<3 'i^oD - r/38'-t!
IDENTIFICATION; Please Print All Information
Mailing Address — No. Street, City and SlateFirst Zip Code Telephone No.Last Name Initial
VC ^I /.-y /<:=*/_'Property
Owner / //i U)7
/'/Ay (L //
ContcactoF-aJ. ST_______
rf](U^o. AJ, 0.
Name
State Lie. It
CHARACTERISTICS OF PROPOSEDPROPOSED PROJECT lOPOSED USE
( ) Residential
) Non-Residential
RESIDENTIAL USE NON-RESIDENTIAL USE
( ) Garage
{ ) Utility Structure
) Water Orientated ^ Accessory Structure^"
r t r.,K ( X ) Other
( ) New Structure
( ) Addition
( X) MH/RV
( ) One Family Dwelling
( ) Multiple Dwelling
# of Units ( )
Basement ( )
Walkout Basement { )
Outside Dimen^n^ ^ i ^
of Structure PS / Ft.
Height of Structure £
# Of Stories
/985 (
YEAR
ONSITE WATER SUPPLYTYPE OF FRAME
( ) Masonry
( ) Wood
( ) Structural Steel
( ) Other
ONSITE SEWAGE
DISPOSAL SYSTEM
Ft.
( ) Public
( > ) Individual
( ) None
OFFICE USE ONLY
) Bluff Impact Zone
) Shore Impact Zone
) Sensitive Area
( ) Public
( yC ) Individual
Permit #_
( ) OTLSD
RV(# Of Bedrooms
M(# Of Bathrooms
(
7^LOT SIZE AND SETBACKS;
_ORuaro feet. Water frontage is mafeet. Maximum depth of lot feet.Lot Area is
Building set back from ordinary high water level is feet. (Siring Test)
3 feet. Slope of lotLand height above ordinary high water level at building line Is %
Building set back from road right-of-way.feet.
50 5*0Lot line setback Is and feel.
/iOStructure will be located feet from septic tank (Sewage System Permit must be obtained before installation).
Structure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation).
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 accord
ing 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
(I understand that it is my responsibility to inform the Land & Resource Management office once the building footings have been constructed.)
Dated:
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.
J
GO . oo
Dated;
Land & Resource Management Office
Permit Fee $.Receipt No..
Comments:
lUr >7U
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^ J jur.. jn.juJiyerrLoieiJlt^ /g
XtreY ((Y) - Ji^ JL^ IC.V
Yr jSjTv 1f^—X^a /^\/
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Form No. BK — 0292-002 270.500 • Victor Lundeen Co Printers • Fergus Falls. MN • 1-800-346-4870
INSPECTION RESULTS
Make all measurements and computations
ACTUAL MINIMUM
Sq. Ft.
Building Set Back from High Water Level Ft.Ft.
Building Set Back from Top of Bluff Ft.30 Ft.
(00 +Building Set Back from Road Right of Way Ft.20 Ft.
50^50*Ft. Ft.Ft. &Building Set Back from Lot Lines
Ft. Ft.Building Height
iOO^Building Set Back from Septic Tank Ft.10 Ft
Ft.20 FtBuilding Set Back from Absorption System
Elevation AboveHigh Water Level at Building Line /0 +3 Ft.Ft.
%Land Slope at Building Line
Inspector's Comments/Sketch:,
C U I (0 S
X
V•y
Do D
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Inspector's Signature
5-A9-S
Date of Inspection
Time of Inspection
Please sketch your lot indicating setbacks from r^ right-of-wa^, lake ana^aeyaro rur ....
on lot and any proposed structures.
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21S98 7®VICT4* LUNOECN CO . PRINTERS. FEROUS FALI.S. UiNN.
Macklanbl'rg-Duncan
CONSUMER PRODUCTS DIVISION
Roger Finch
TERRITORY M.^NAGER
2602 N. 3rd Street, Fargo, ND 58102
PHONE; 701-237-3328 or 800-654-8454
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Dated:19
Signature
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Signature
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A/o7&’,(k/£f,T y^euF Le^S, Poo/C)21S987@MKL-0871-029
VICTOR LUNDEEN CO.. PRINTERS, PCfiCUS TalI-S,
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
WHITB-— OfTce
GOLDENROD — Inspector
YELLOW — Owner
PINK — Assessor
Permit No.LEGAL
DESCRIPTION
AND
LOCATION
SECTION TWP NO.RANGELAKE/RIVER
CLASS TWP NAMELAKE NUMBER LAKE/RIVER NAMEn 3^) ^ C/v ^2JKl^5 j.')^/l Cj P
FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER (S)
IDENTIFICATION: Please Print All Information
Mailing Address — No. Street, City and State Zip Coda Teiephone No.First InitialLast Name
Si>l)Property
Owner
NameContractor
state Lie. #
PROPOSED PROJECT PROPOSED USE RESIDENTIAL USE
( X ) One Family Dwelling
( ) Multiple Dwelling
# of Units ( )
NON-RESIDENTIAL USE
( ) Garage .
( ) UtilitytStructure
( ) WaterOrientated
Accessory Structure
CHARACTERISTICS OF PROPOSED
( X) Residential
( ) Non-Residential
( ) New Structure
( -y() Addition
( ) MH/RV
Basement (/- )
Walkout Basement )
Outside Dimension 2.^;
of Structure, Ft.ZITr.YEAR
TYPE OF FRAME
( ) Masonry
( )OWood
( ) Structural Steel
( ) Other
ONSITE SEWAGE
DISPOSAL SYSTEM
( ) Public
( ) OTLSD
ONSITE WATER SUPPLY
( ) Public
( X ) Individual
( ) None
( ) Other Height of Structure.
# Of Stories______IOFFICE USE ONLY
(,t3 /) Bluff Impact Zone
/) Shore Impact Zone
( ) Sensitive Area
# Of Bedrooms
C-!If Of Bathrooms
LOT SIZE AND SETBACKS:
H A)-J5'o O
Lot Area is square feet. Water frontage is feet. Maximum depth of lot feet.
feet. (String Test)Building set back from ordinary high water level is
7
feet. Slope of lotLand height above ordinary high water level at building line is %
£Building set back from road right-of-way.feet.
Lot line setback is and feet.
Structure will be located feet from septic tank (Sewage System Permit must be obtained before installation).
Structure will be located feet from soil absorption system (Sewage System Permit must be obtained before installation).
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.
Dated:
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.
Dated:
Land & Resource Management Office
Permit Fee $.Receipt No.
i/.JS^f 4^ r t yComments:
Dtr^-Ao /'3f
^ re~Ta7j 7/G_i /o'y ^3. S '
Form No. BK — 0292-002 262,316 — Victor Lunde«fl Co.. Printers, Fergus Falls, Minnesota
.: 7»^ "'., y - •TH ’ -■WT I auv"•• r**
')(OTTER TAIL COUNTY DEPT. OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
, COURT HOUSE
FERGUS FALLS, MN 56537
218-739-2271
O
)
PLAN REVIEW RECORD
r
V- /V- f'V'Date
,O^A/yUBusiness NameOwner!. Uj
AddressAddress
Type of Business C ^
N/A;Date:
Permits applied for (township, city, county)
Shoreland Management approval
Department of Natural Resources approval
Pollution Control Agency approval
Plans & specifications in writing
MDH approval for plumbing
MDH approval for swimming pools
State Fire Marshal approval
'3>n¥ -The plan has been reviewed for the standards of the:p, ^:U‘Food, Beverage Ordinance
___ Lodging Ordinance
Recreational Camping Area, Mobile Home Park Ordinance
The plan is approved as submitted:Yes No
P )
The following items must be corrected to meet the Standards:
fl I l(L Al l ll/Ju/U/)/O tl/jJ ChAAJJ ‘C.(
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y/CUAJlP UoPublic Health
Sanitarian
Date u9tr>^
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IScale:' Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM
OflfDated:19
Signature
Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently
on lot and any proposed structures.^ LA 3 r.
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\^e5MKL-0871-029 21S987®
viereR lunoiem e«.. VHitiTEHt. rcReus fALLt. hinn.
t3
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
WHITE — Office
GOLDENROQr— Inspmtor
YELLOW — Owner
PINK — Assessor
)2. Sfg'Permit No.LEGAL
DESCRIPTION
AND
LOCATION
SECTION TWP NO.RANGE TWP NAMELAKE NUMBER LAKE/RIVER NAME LAKE/RIVER
CLASSRiajJv 3^2J'I'/)Qd
FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER (S)
55-555'1?3 - 0/3^ • 550 /
IDENTIFICATION: Please Print All Information
Zip Code Telephone No.Mailing Address — No. Street, City and StaleFirst InitialLast Name
r'-5^45'))Property
Owner
T 14'NameContractor
State Lie. #
CHARACTERISTICS OF PROPOSEDRESIDENTIAL USE
( X ) One Family Dwelling
( ) Multiple Dwelling
ft of Units ( )
NON-RESIDENTIAL USE
( ) Gafage
( ) Utility Structure
( ) Wat^rDrientated
Accessory Structure
( ) Other
PROPOSED PROJECT PROPOSED USE
( X) Residential
) Non-Residential
Basement ()l/'.»)
Walkout Basement )
Outside Dimension 9 2*'j
of Structure___________**
) New Structure
Addition
(
( ) MH/RV
(
Ft.YEAR ^Ft.
ONSITE WATER SUPPLY
( ) Public
( )() Individual
( ) None
TYPE OF FRAME
( ) Masonry
()()
( ) Structural Steel
( ) Other
ONSITE SEWAGE
DISPOSAL SYSTEM
( ) Public
( ) OTLSD
Height of Structure.
# Of Stories______}
OFFICE USE ONLY
( /g /) Bluff Impact Zone
I) Shore Impact Zone
( ) Sensitive Area
c>Wood # Of Bedrooms
o# Of Bathrooms
LOT SIZE AND SETBACKS:
XLot Area is u> ^square feet. Water frontage is feet. Maximum depth of lot feet.
nsBuilding set back from ordinary high water level is feet. (String Test)
3 feet. Slope of lotLand height above ordinary high water level at building line is________%
Building set back from road right-of-way.feet.
Lot line setback is and feet.
Structure will be located feet from septic tank (Sewage System Permit must be obtained before installation).
5?^
Structure will be located. .feet from soil absorption system (Sewage System Permit must be obtained before installation).
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.
.Jy 43^v<^VWyDated;
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.
Dated:
Land S Resource Management Office
Permit Fee $,Receipt No_
^-7^ 9^//Comments: 3C.
-Xo /p-Q-
^ r r Ftyry t v:O/ ,
7-ffl ^
✓u ±
Form No. BK — 0292-002 %2,316 — Victor Lundoon Co., Printers, Fergus Falls, Minnesota
J
INSPECTION RESULTS
Make all measurements and computations
ACTUAL MINIMUM
Sq. Ft.
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft.Ft.
loo^Building Set Back from High Water Level Ft.Ft.
aJ/MBuilding Set Back from Top of Bluff Ft.30 Ft.
/ootBuilding Set Back from Road Right of Way 20 Ft.
/3Building Set Back from Lot Line Set Back Ft. &Ft.
4/<PBuilding Height Ft. Ft.
So^Building Set Back from Septic Tank Ft. 10 Ft
/OO^Building Set Back from Absorption System
Elevation Above
High Water Level at Building Line
Ft.20 Ft
5^Ft.3 Ft.
Land Slope at Building Line %
Inspector's Comments:
Sketch:
\ i-i'
Inspector's SignatureI 5-/-9S■
Date of Inspection
f
/Time of Inspection
\I}
P, 02FAX NO. 020
mi
021flUG-12-96 BON i5j25 _ |
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Line.
1" = 12’
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156' to well
45'
n
10’
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10' X 20'
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60'
✓
Resort property line
North
APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
WHITE — Office
GOLDENROD — Inspector
YELLOW — Owner
PINK — Assessor
SuL Ic-I- I
' 3
iX3(rOPermit No.LEGAL
DESCRIPTION
G'C>^ •AND
LOCATION
RANGE TWP NAMESECTIONTWP NO.LAKE/RIVER
CLASSLAKE/RIVER NAMELAKE NUMBER
3 I a(-(RSt-Hf 6-i) ;i3 135
FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER (S)
53-&00 -J. 3 -oiz^t-oao
IDENTIFICATION: Please Print All Information
Zip Code Telephone No.Mailing Address — No. Street, City and StateFirstInitialLast Name
^0% a t !c-ZS7/Property
Owner
CJlI 995NameContractor
State Lie. # ^
CHARACTERISTICS OF PROPOSED
Basement
Walkout Basement
Outside Dimension. ' ^of Structure fO 190 Ft.
Ft.
RESIDENTIAL USE NON-RESIDENTIAL USE
( ) Galtege .
( ) Utilit^v^tpii^re
PROPOSED USEPROPOSED PROJECT
( PC ) 0ri6 Family Dwelling
( ) Multiple Dwelling
# of Units ( )
( Residential
( ) Non-Residential
New Structure
(^) Addition
( ) MH/RV () Watpf Orieht^ed
Ac^ssory StructureYEAR
ONSITE WATER SUPPLYONSITE SEWAGE
DISPOSAL SYSTEM
TYPE OF FRAME
( ) Masonry
( ) Wood
( ) Structural Steel
( ) Other
Height of Structure.
# Of Stories______
( ) Other /( ) Public
(‘'^) Individual
( ) None
A OFFICE USE ONLY
) Bluff Impact Zone
) Shore Impact Zone
( ) Sensitive Area
( ) Public o# Of Bedrooms
( V ) Individual
Permit #_
( ) OTLSD
o# Of Bathrooms
LOT SIZE AND SETBACKS:
9^0 square feet.iWr^^eet.feet. Maximum depth of lotWater frontage isLot Area is
ys feet. (String Test)Building set back from ordinary high water level is
feet. Slope of lot %Land height above ordinary high water level at building line is
> SO feet.Building set back from road right-of-way.
So ^So feet.andLot line setback is
/o feet from septic tank (Sewage System Permit must be obtained before installation).Structure will be located
feet from soil absorption system (Sewage System Permit must be obtained before installation).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.
A"' ^Dated:
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 expres
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. / J
Dated:
. Land & Resource Management Office
Receipt No./lIH^Permit Fee
(^■f 9ra//dr €>COh _______
O fl^cJ ,___________________
SO'f2
<Qe*JiComments:
jO~e A—/ y gC/
f
/
)Form No. BK — 0292-002 262,316 — Victor Lundeen Co., Printers, Fergus Palis, Minnesota
../!APPLICATION FOR SITE PERMIT
LAND & RESOURCE MANAGEMENT
OTTER TAIL COUNTY COURT HOUSE
Phone: (218) 739-2271 • FERGUS FALLS, MN 56537
WHITE — Office, GOLDENROD — InspeCtt^
YELLOW — Owner
PINK — Assessor
) i ,
\
~S(aL !o^ /4-'l3iS0OaPermit No.LEGAL
DESCRIPTION
i 3 *AND
LOCATION
TWP NAMETWP NO.RANGESECTIONLAKE/RIVER
CLASSLAKE/RIVER NAMELAKE NUMBER
^ it3^5(, Ii!6-D 13 5
FIRE OR LAKE ASSOCIATION NUMBERPARCEL NUMBER (S)
53-000 3 -<9 /3 7- OOO
IDENTIFICATION: Please Print All Information
Telephone No.Zip CodeMailing Address — No. Street, City and StateInitialFirstLast Name
3)u 5'CT?/ioo /Property
Owner
Qj 9YS-2233n. g z'Name 1Contractor
State Lie. # ^
CHARACTERISTICS OF PROPOSED
Basement
Walkout Basement
Outside Dimension
of Structure
NON-RESIDENTIAL USE
( ) Garage
( ) Utility Structure
( ) Water OriefH^ted
Accessory Structure
( ) Other
RESIDENTIAL USE
(^ ) One Family Dwelling
( ) Multiple Dwelling
# of Units ( )
PROPOSED USE
(^ ) Residential
( Non-Residential
PROPOSED PROJECT
(fpi-) New Structure
) Addition ^
( ) MH/RV
1 ^-r JC Ft.
g ' Ft.
YEAR
ONSITE WATER SUPPLYONSITE SEWAGE
DISPOSAL SYSTEM
TYPE OF FRAME
( ) Masonry
( ) Wood
( ) Structural Steel
( ) Other
Height of Structure,
# Of Stories______I( ) Public
('yO. ) Individual
( ) None
OFFICE USE ONLY
) Bluff Impact Zone
) Shore Impact Zone
) Sensitive Area
{ ) Public
(V ) Individual
Permit #.
( ) OTLSD ^
O# Of Bedrooms
# Of Bathrooms
I
LOT SIZE AND SETBACKS:
'< square feet.feet. Maximum depth of lotWater frontage IsLot Area is
7S feet. (String Test)Building set back from ordinary high water level is
Land height above ordinary high water level at building line is 3 %feet. Slope of lot
feet.Building set back from road right-of-way.
So ^Sn feet.andLot line setback is
/o .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).
Structure will be located
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.
'7' / fvl.
A'I
■ •<Dated:I
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 expres:
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.
Dated:
Land S Res^rce Management Office
Receipt No..Permit Fee
^ (0-f ^ra//ar /i>~S QCO K
-t' -Y- f f /7 6i~ tO-e r/vi gt o j
^ ^ u A V,/ B-t i./ /O'f f u-'isf ( ^ X.
Comments:
fY- T- 9-:?
Form No. BK — 0292-002 262,316 — Victor Lundeen Co., Printers, Fergus Falls, Minnesota
T--.r'-V-'. v.yr^* -u: ■• * ’•.'JW
I
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.
Building Set Back from Top of Bluff Ft.30 Ft.
Building Set Back from Road Right of Way Ft.20 Ft.
I:l'Building Set Back from Lot Line Set Back Ft. & Ft. Ft.
Ft. Ft.Building Height
MBuilding Set Back from Septic Tank Ft.10 Ft
Building Set Back from Absorption System Ft.20 Ft
Elevation AboveHigh Water Level at Building Line 3-r Ft.3 Ft.
mlLand Slope at Building Line o/o
Lac/c\icI<_______Inspector’s Comments:
\JiCu>C^ (K I oc
Sketch:
0
Inspector's Signature
Date of InspectiQn
Time of Inspection
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White — Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone: (218) 739-2271 - Fergus Falls, Minnesota 56537
APPLICATION FOR SITE PERMIT
SillPermit No^LEGAL
DESCRIPTION
AND
LOCATION
37
Range ' TWP Name^ Lake Name
feD 53 JE6
TWPLake Classif.Sec.Lake No.
IDENTIFICATION: Please Print All Information
Tel. No-Zip No.Mailing Address— No. Street. City and State________________
i&J /j£f^68t)L
Initialjirst__________
NemT ^iZeX^ (GZHZLtuJ). yZhn
Last Name
Owner
i ,/
Contractor
SZ.S'?/
Architect Name.
NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:
New Building
( ) Alteration
( )Other_____________
Specify:.( ) One Family Dwelling
( ) Multiple Dwelling Units
jk.Other Size
IESTIMATED COST OF IMPROVEMENTS
DIMENSIONS:
Basement: ( ) Yes No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms .......
TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:
( ) Public
Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
(M Individual Well
( ) Masonry
(^ Wood Frame
( ) Structural Steel
( ) Other — Specify
/.
wirBaths
CHARACTERISTICS: ^
feet.Maximum depth of iot feet.Water frontage issquare feet.Lot Area is
feet. (Building Line)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
3 feet
^ o .feet.feet — from road right of way is
/ola.feet.
.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).
and
/.a.<^oStructure 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 ONL Y AND DOES NOT CONSTITUTE A BUILDING PERMIT AS SET FORTH IN CHAPTER 16, MINNESOTA STATE STATUTES.
I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand
I must contact my township in order to determine whether or not any additional permits are required by the township for my proposed project.
Dated.y / L,_______
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.
rm/7nAShoreland Mana^r^nt Official
30- o o
Dated
Permit Fee $.Receipt No.
^!i/\ t C'sf^ c5- _____
/-lx,euujL^
3 vrcCS^NDC^ro^l^TE^*?ERGus falls. MINN.
rX^v\Comments;
)
■2’^^_______J?<—
Form No. MKL-0286-019-<^
White — (-,«•
GoJdenrn^ “ Inspector
SHORELANO MANAGEMENT - COUNTY OF OTTER TAIL
COUNTY COURT HOUSE
Phone: (218) 739 -2271 — Fergus Falls, Minnesota 56537
APPLICATION FOR SITE PERMIT
// ' 7Permit No„lEGAL
DESCRIPTION
AND
LOCATION
7 ’ t /jv7i'o iJ -7 /// y :: .'■V
TWP NameSec.RangeLake Classif.TWPLake NameLake No.
IDENTIFICATION: Please Print All Information
Zip No.Mailing Address— No. Street. City and State Tel. No.First InitialLast Name
. i.I )UJ.-L' L t /,/ /V.I}/■''uJLOwner
//i.ni/U '/'/ / /I\fi u'y - i.7'“ /V W I t1 I/ >/ .K' 7 ( ,(.fNameContractor
Architect Name.
NON-RESIDENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:
F\) New Building
( ) Alteration
■V r' iV--')(.t Specify:.( ) One Family Dwelling
( ) Multiple Dwelling
(X )Other
Units
( ) Other Size
ESTIMATED COST OF IMPROVEMENTS
DIMENSIONS:
Basement: ( ) Yes iXj No
Stories above basement: .............^.1..
Sq. feet (outside dimension)....
Bedrooms
TYPE OF SEWAGE DISPOSAL;
( ) Public
Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
Individual Well
PRINCIPAL TYPE OF FRAME:
( ) Masonry
(A) Wood Frame
( ) Structural Steel
( ) Other — Specify
77...
i '
:
Baths
CHARACTERISTICS:
Lot Area is 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....
and
Maximum depth of lot feet.feet.
T y r ^
T.......feet. (Building Line)
feet
r.).feet.feet — from road right of way is
...............feet.
.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).
Side yard is
Structure will be located
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.
I understand that I have been granted a site permit in accordance with the requirements of the Shoreland Management Ordinance of Otter Tail County. I understand
I must contact my township in order to determine whether or not any additional permits are required by the township for my proposed project.
5\
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.
■ /v,. /Dated
Shoreland Manag^ent OfficialC.lOz4r (/Permit Fee $.Receipt No.\
_L "TP.- ' (- -1.Comments:f /a3/r^!z'T-4 . r hr--A»’7yH) - LT 7 ()- 7
X' .■2.i'' • ■ll ■-1
7 T ✓~nyi—>--•.i'-r xf".T~TT -■■--•.vu:.
229971 @ vicrijR■^jNDCEN CO.. 1*^Form No. MKL-0286-019 1
FERGUS FALL.S. MINN.
NTKRS,
f
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL
IS i
MINIMUM
Shall Be ^Sq. Ft,
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft.Ft.
Building Set Back from High Water Mark Ft.Ft.
Building Set Back from State Highway Ft.50 Ft.
Building Set Back from Street or Road Ft.40 Ft.
Side Yard &Ft. &Ft.
Rear Yard Ft.Ft.
Occupied Building to Septic Tank Ft.10 Ft.
Occupied- Building to Absorption-S'Ft. 20 Ft.:em
Elevation at Building Line above
High Water Mark_____________Ft.3 E.
ii^nts:( ^ Ki
Inspector's Com
t:
/ij?
i \LUJJM
V
LT'
L-l-ADInspector's &i^nature
I
Inspectiol
Dated
Agei cy
viCTOK uiNOCCH > CO MiMTCR*. riotut r<4.«.*. mint.
feet/inchesScale: Each grid equals GRID PLOT PLAN SKETCHING FORM
Dated 19 Signature
Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently
on lot and any proposed structures.
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21598 7®MKL-0871-029
VICTOn LUNDCCN . PAtMTEfIS. FERGUS FALLS. VlNN.
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
White — Office
Yellow ^ Owner
Pink — Assessor
Goldenrod — Inspector
¥
//- /Yf?so<s>d- „Permit No„LEGAL
Date.DESCRIPTION
AND
LOCATION
:3.30(r '4 /2
Lake No.Lake Name Lake Classif.Sec.TWP TWP NameRange
IDENTIFICATION: Please Print All Information
Last Name First Initial Mailing Address— No. Street. City and State Zip No.Tel. No.
hc^^tC&
Ar X ^6-/I ^JJLJaOwner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT;RESIDENTIAL PROPOSED USE;NON-RESIDENTIAL PROPOSED USE:
CLobdthuI ) New Building
(v'KJCiteration ^ ^
iXlthTr_____^^0 A"
( ) One Family Dwelling
( ) Multiple Dwelling
( ) Other
Specify:.
Units
(Size
ESTIMATED COST OF IMPROVEMENT $ ^ SQO .(omit cents)
PRINCIPAL TYPE OF FRAME;TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
( ) Structural Steel
( ) Other — Specify
( ) Public
j(..,J-+ndividual Septic Tank, etc.
WATER SUPPLY:
( ) Public
(fc.+'TnSivTdual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning; ( ) Yes
( ) Central
Basement: ( ) Yes ( ) No
Stories above basement;
Sq. feet (outside dimension)
Bedrooms ...........^..
rame
Baths
HEATING;
( ) Electric
( ) Coal
Other;
Type of Roof:( ) No
( ) None
( ) Oil
( ) No
( ) Unit
CHARACTERISTICS:
....Lot Area Is square feet.Water frontage is 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. (Building Line)
2^.feet
.....feet — from road or street is feet.
lo.....cS-iS.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.
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-thi
shall become a part of this permit application. I also understand that this permit is valid for a pericfSof six (6)
7-/ / - 7^Dated.
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
J 76Permit Fee $ <6?- O D State Surcliarge $.
Comments:cJA-^ -'Ljl) jUojL.AD
Form No. MKL-0771-002 VICTOR u>HPC(« t CO.. Ptionoi. rcoouo fm-li. hihm 158899
1
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
White — Office
Yellow — OwnerPink -rf^Assessor
Goidenrod - Inspector
t
Permit No,LEGAL
■ Vi7 Date.DESCRIPTION
AND
LOCATION
f
TWP NameLake No, Lake Name Lake Classif.Sec.TWP Range
IDENTIFICATION: Please Print All Information
Last Name First Initial Mailing Address— No, Street. City and State Tel. No,Zip 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
( ) None
Type of Roof:( ) No ( ) Oil
( ) No ( ) Coal
Other:( ) 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.
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.
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 Surcfiarge $.
Comments:
\CXON.rii i i1
Form No. MKL-0771-002
vicToa ujiiaecH a eo.. p*iHTf*i. fersus rN.Li.
1S8899
1
\
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL IS i MINIMUM
Shall Be ^Sq. Ft,
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft.Ft.
Building Set Back from High Water Mark Ft. Ft.
Building Set Back from State Highway Ft.50 Ft.
Building Set Back from Street or Road Ft. 40 Ft.
Side Yard &Ft.&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_____________Ft.3 Ft.
Inspector's Comments:
I nspect or's § Ig natu re
Title
Inspection
Dated 19
Agency
VlCTOK UJMDECH « CD . DDIMTCDC. rCDDWD fALk*.
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
White^ - Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
A
Permit No„LEGAL
Date.DESCRIPTION
AND
LOCATION
TWP Name ' ^
A
Lake No.Lake Classif.Sec.Lake Name TWP Range
IDENTIFICATION: Please Print All Information
Last Name Ftyt_____Initial Mailing Address— No. Street. City and State Zip No.Tel. No.
I /______A\ V\.|Oir-<A-r^Owner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
( l>New Building
( ) Alteration
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
Units
Size 3d ;r Q( )Other (_1-Other
ESTIMATED COST OF IMPROVEMENT $ SOGCi (omit cents)
PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
(ulHlffood Frame
I ) Structural Steel
( ) Other — Specify
( ) Public
(-^r^dividual Septic Tank, etc.
WATER SUPPLY:
( ) Public
('T^dividual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
Basement: ( ) Yes
Stories above basement:
Sq. feet (outside dimension)
BedroomsAJcm^Baths
HEATING:
( ) Electric ( ) Gas ( ) Oil
( ) None
Type of Roof:(-)-No
(( ) Coal
Other:7( ) 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 >3.
.Y.O.,>5jO.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.
i>'oand 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.
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 Mree that any plans and specifirations submitted herewith
shall become a part of this permit application. I also understand that this permit Is valid for a perioi six ipnths.
/><iDated.
Signatu^ 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.
Shoreland Mana^ment (Official
As /?ADated
State Surcliarge $ ^•^7 70Permit Fee $
Comments:
Form No. MKL-0771-002 158899vicTea LUMoeiM 4 eg.. paiHTiiie. rii«ui rM.Lt.
r
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
White_- Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspectori
Permit No..LEGAL
Date.DESCRIPTION
AND
LOCATION
Lake No.Lake Name Lake Classif.Sec.TWP TWP NameRange
IDENTIFICATION: Please Print All Information
Last Name First Initial 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
( ) Other
Specify:.
Units
( ) 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
( ) Coal
Other:
Type of Roof:( ) No ( ) Gas
{ ) None
( ) Oil
( I No
( ) 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.
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.
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.
i
Dated,
Signature of Owner
Permit:
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.
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the
Dated
Shoreland Management Official
Permit Fee $.State Surcharge $.
Comments:
»gOT CA Li rD FI LEDS-£ "77
iForm No. MKL-0771-002 1S8899
VICTOK UINPCCN 4 60.. PRINTER!. FCRRU! FALk!.
V
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL
IS I MINIMUM
Shall Be ^Sq. Ft.
Lot Area (Square feet)Sq. Ft Sq. Ft.
Water Frontage Ft.Ft.
Building Set Back from High Water Mark Ft.Ft.
Building Set Back from State Highway Ft.50 Ft.
Building Set Back from Street or Road Ft.40 Ft.
Side Yard &Ft.&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_____________Ft.3 Ft.
Inspector's Comments:
Inspector's Signature
Title
Inspection
Dated 19
Agency
®
VICTQH UIHOtCH t CO . PdlMTIOO. rCIOUO fM.Lt. MINN.
i
r 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
Office
Owner
White.;
Yellow
Pink — Assessor
Goldenrod — Inspectort
Permit No„LEGAL
yj>s~Date,DESCRIPTION
AND
LOCATION
A )<r.CttIO 7 ^
TWP NameTWPRangeLake Classif.Sec.Lake No.Lake Name
IDENTIFICATION: Please Print All Information
Mailing Address— No. Street. City and State Zip No.Tel. No-Last Name First. Initial
Owner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
{i„yt)ne Family Dwelling
( ) Multiple Dwelling
( ) Other
( ) New Building
(t-F’^Clteration
Specify:.
Units
( ) Other Size
ESTIMATED COST OF IMPROVEMENT $(omit cents)
PRINCIPAL TYPE OF FRAME: TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
{.-ri^o( ) Masonry
(|>^Wood Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
(—f^ndividual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( —f-^dividual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
Basement: ( ) Yes
Stories above basement:
Sq. feet (outside dimension)
Bedrooms ........^3...............
/
1Baths
HEATING:
( ) Electric ( ) Gas
( ) None
( M4oType of Roof;( ) Oil
( ) Coal
Other:( ) Unit
CHARACTERISTICS:
.kr...A.Lot Area is square feet.Water frontage is.
feet. (Building Line)
...............................feet
feet.
Z^.±.Building set back from high water mark is
Land height above high water mark at building line is
V(3-f...............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.
.V.D.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.
.....70 .7^.
.....sn?C..'/...
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 furthpr-a§ree tharaoy plans and specifications submitted herewith
shall become a part of this permit application. I also understand that this permit is valid for a pei/od of six (6) nuliths. yt
yVDated.JUL
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.
9 /jy /> ^Dated
Shoreland Management Official
MU.Permit Fee $State Surctiarge $.
Comments:
Form No. MKL-0771-002 158899
VICTOR UJNDCIN 4 CO.. RRlHTCRO, FCROUO r*Ll.O.
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
White - Office
Yellovv — Owner
Pink — Assessor
Goldenrod — Inspector
Permit No_// f*v'LEGAL
■ e Date.DESCRIPTION
AND
LOCATION
i;
Lake No.Lake Classif.Sec.Lake Name TWP Range TWP Name
IDENTIFICATION: Please Print All Information
Last Name First Initial 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:
I ) New Building
( ) Alteration
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
Units
/. ( ) Other ( ) Other Size
ESTIMATED COST OF IMPROVEMENTS (omit cents)
PRINCIPAL TYPE OF FRAME;TYPE OF SEWAGE DISPOSAL:DIMENSIONS:
( ) Masonry
( ) Wood Frame
( ) Structural Steel
( ) Other — Specify
I ) Public
( ) Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air (^nditioning: ( ) Yes
( ) Central
Basement: ( ) Yes ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms Baths
HEATING:
( ) Electric ( ) Gas
( ) 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.
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.
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:
ivrnT HALLFD FILED5-QS77
■f-
Form No. MKL-0771-002
VICTOR UfNOCCN 4 CO.. ROIHTIRO. riOOuS FALLS.
158899
V*
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL IS 1 MINIMUM
Shall Be ^Sq. Ft.
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft.Ft.
Building Set Back from High Water Mark Ft. Ft.
Building Set Back from State Highway 50 Ft.Ft.
Building Set Back f 'om Street or Road 40 Ft.Ft.
Side Yard &Ft.&Ft.
Rear Yard Ft.Ft.
Occupied Building to Septic Tank 10 Ft.Ft.
Occupied Building to Absorption System Ft.20 Ft.
Elevation at Building Line above
High Water Mark_____________Ft.3 Ft.
Inspector's Comments:
1 nspector's^ig nature
Title
Inspection
Dated 19
Agency
VICTOK LUHDCCH » M . rCDSU* fALL*. MIIIN.
S
•f
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
White - Office
Yelic’w — Owner
Pink — Assessor
Goldenrod — Inspector
«
Permit No,./LEGAL
Date.DESCRIPTION
AND
^ 3LOCATION
y35~ 39
TWP NameSec.TWP RangeLake Classif.Lake No. Lake Name
IDENTIFICATION; Please Print All Information
Zip No.Tei. No.Mailing Address— No. Street, City and StateInitialFirstLast Name
:Fk/y-r\ ,Z<y}y7^ AD./QjocJOwner
NameContractor
Architect Name.
NON-RESIOENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:
I Building
( ) Alteration
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
Units
( ) Other( ) Other Size
ESTIMATED COST OF IMPROVEMENT $(omit cents)
TYPE OF SEWAGE DISPOSAL:DIMENSIONS:PRINCIPAL TYPE OF FRAME:
Basement: ( ) Yes ( ) No
Stories above basement: ........
Sq. feet (outside dimension).....
Bedrooms
( ) Masonry
(^>Wood Frame
( ) Structural Steel
( ) Other — Specify
( ) Public
(—individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( lifidividual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
.3,Baths
HEATING:
( ) Electric
( ) Coal
Other:
(cLjSaS^ ( ) Oil
( ) None
( ) NoType of Roof:
{ ) No
( ) Unit
CHARACTERISTICS:
>!.:&:..A.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 3.±r..
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. Rear yard is ..................................feet.
feet from septic tank (Sewage System Permit must be obtained before installation).
feet.
JLCDFand
feet from soil absorption system (Cesspool, Drainfield, etc.).
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 si:lonths.
ADated.4.
Signaturafof (Jwner
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/
F..S State Surcharge $.Permit
Comments:
Form No. MKL-0771-002
vicToi) uiMOClM 4 eo.. paiHTiei, riiuus rM.L*.
,158899
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
White — Office
Yellow — Owner
Pink — Assessor
Goldenrod — Inspector
Permit NoLEGAL
/Date./ -'iyDESCRIPTION
AND
LOCATION
Lake No.Lake Classif.Lake Name Sec.TWP Range TWP Name
IDENTIFICATION: Please Print All Information
Last Name First Initial 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:
( I 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
( ) Coal
Other:
Type of Roof:( ) No ( ) Gas
( ) None
( ) Oil
( ) No
( ) Unit
CHARACTERISTICS:
lie...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.
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.
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 •r
Signature of Owner
Permit:
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.
Permission is hereby granted to the above named applicant to perform the work described in the above statement. This permit is granted upon the
Dated
Shoreland Management Official
Permit Fee $.State Surcharge $.
Comments:
r.^D5-9^77NOTo /> T T r
iForm No. MKL-0771-002
VICTOR UMieCCH t C«.. PRINTCR*. FCRSua ri«.LR.
,158899
INSPECTOR'S CHECK LIST
Make all measurements and computations
ACTUAL IS X MINIMUM Shall Bej Sq. Ft.
Lot Area (Square feet)Sq. Ft.Sq. Ft.
Water Frontage Ft.Ft.
Building Set Back from High Water Mark Ft. Ft.
Building Set Back from State Highway Ft.50 Ft.
Building Set Back from Street or Road 40 Ft.Ft.
Side Yard & Ft.&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_____________Ft.3 Ft.
Inspector's Comments:
Inspector's Signature
Title
Inspection
Dated 19
Agency
VICTOII LUHOKCH i 00 . PHIMTCM. riMOWO fM.1.0. HIIIH.
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
White — Office
Yellow — Owner
PliVk — Assessor
Goldenrod — Inspector
i
(.o ^Rcsott Permit No„/{y\Ay [LEGAL 3 ^ -3-3 r7.aDate.DESCRIPTION
AND
HOo-LOCATION
(5X) ^3 ^3^
' Lake Name Lake Classif.Sec.TWP Range TWP NameLake No,
IDENTIFICATION: Please Print All Information
Mailing Address— No. Street. City and State Tel. No.Last Name First Initial Zip No.
y^/i/^V ( //vy1-^^OaOwner
NameContractor
Architect Name.
TYPE OF IMPROVEMENT:
Ifrl^New Building
( ) Alteration
RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
Units1I)Other ( ) Other Size
ESTIMATED COST OF IMPROVEMENT $ P^OOC (omit cents)y
TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:DIMENSIONS:
Basement; ( ) Yes ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms
( ) Masonry
( ) Wood Frame
I ) Structural Steel
( ) Other — Specify
( ) Public
( ) Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
Baths
HEATING;
( ) Electric ( ) Gas
( ) Coal
Other:
( ) NoType of Roof:( ) Oil
( ) No ( ) None
( ) Unit
CHARACTERISTICS:
J£...V ,3yZsquare feet.Lot Area is Water frontage is 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. (Building Line)
.feet
.....
....
feet — from road or street is
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.
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^.months.
Dated./’=Si!
Permit: Permission is hereby granted to the above named applicant to perform the work describee 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 ordinances of Otter Tail
County, Minnesota. This permit may be revoked at any time upon violation of said ordinances.
Dated
Shoreland Management Official
Fee State Surcharge SPermit
Comments:
Form No. MKL-0771-002 @ VICT9K LUaeCCN 4 00.. PXMTtOI. rCKOUO FM.L4.158899
■ iSHORELAND MANAGEMENT - 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
Yeiiow — Owner
Pi;*k — Assessor
Goidenrod — inspector
»
t.Permit No,.He Co f rA/LEGAL
rV ■ c"Date,DESCRIPTION
AND
LOCATION
TWP TWP NameLake Name Lake Classif.Sec.RangeLake No.
IDENTIFICATION: Please Print All Information
First Initial Mailing Address— No. Street. City and State Zip No.Tel. No.Last Name
Owner
NameContractor
Architect Name,
TYPE OF IMPROVEMENT:RESIDENTIAL PROPOSED USE:NON-RESIDENTIAL PROPOSED USE:
' - 1( ) New Building
( ) Alteration
( ) One Family Dwelling
( ) Multiple Dwelling
Specify:.
i1 Units7■,t
( ) 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
( ) 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:
m—CERTIFICATE- ISSUED
Form No. MKL-0771-002
VICTO* LUHCrCM 4 CO.. FRtNTtllt. fCReua talls.
158899
I
INSPECTOR'S CHECK LIST
Make all measurements and computations
MINIMUM
Shall Be ^ Sq. Ft,ACTUALIS 1
Sq. Ft.Sq. Ft.Lot Area (Square feet)
Ft.Ft.Water Frontage
Ft.Ft.Building Set Back from High Water Mark
&
50 Ft.Ft.Building Set Back from State Highway
40 Ft.Ft.Building Set Back from Street or Road
&Ft.Ft.&Side Yard
Ft.Ft.Rear Yard
10 Ft.Ft.Occupied Building to Septic Tank
20 Ft.Ft.Occupied Building to Absorption System
Elevation at Building Line above
High Water Mark_____________3 Ft.Ft.
Inspector's Comments:
’ Irispecfor's Sjgnrf^n
Title
Inspection
Dated /fi 2-
Agency
fVICTOK LUNBIIM i CO . PRIMTCKS. fCROU* FALL!. HIHH.
i