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Home My WebLink AboutLost Valley Resort_08000150100001_Shoreland Permits_White — Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY •; Permit No„LEGAL y~3 Z5Date.DESCRIPTION AND LOCATION 5U-57Q Lake No. Lake Nam^^ Rn /3 7 RangeLake Classif.Sec.TWP 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: ...(Xcld4-.iioY\----ijQ 5! I ) New Building (L-F'?(it^ration ( ) One Family Dwelling ( ) Multiple Dwelling ( -rOther Specify;, Units /oy n( ) Other Size ESTIMATED COST OF IMPROVEMENT $ — [(omit cents) PRINCIPAL TYPE OF FRAME:TYPE OF SEWAGE DISPOSAL:DIMENSIONS: ( ) Masonry (“'f^ood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( W''TnSividual Septic Tank, etc. WATER SUPPLY: ( ) Public (t+'lndividual Well MECHANICAL EQUIPMENT : Elevator: ( ) Yes Air Conditioning: ( ) Yes ( ) Central Basement: ( ) Yes { ) No Stories above basement: Sq. feet (outside dimension) Bedrooms U.Q.. Baths HEATING: ( ) Electric ( ) Coal Other: Type of Roof:( ) Gas ( ) None ( ) Oil (-<No ( ) Unit CHARACTERISTICS; .3....A.,t 30Q.tLot Area is equal U"(UUt.Water frontage is , feet. (Building Line) ...............................feet feet. it Building set back from high water mark is t^nd 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 z.50.±.501feet — from road or street is feet. 1:0.1..^Q.Land 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. .c^0..i. 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 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 Management Official Dated 50 0 b( 111 ft i Yi^ Permit Fee $.State Surcharge $. oL(\’^er 4-Kav\eicUUiaComments: ^3 Form No. MKL-0771-002 VICTOR LU«DCC« 4 CO.. POmTERO. rCOOUO r«4.Lt. MIHH 158899 White - Office Yellow — Owner Pink — Assessor Goldenrod — Inspector SHORELAND MANAGEMENT - COUNTY OF OTTER TAIL COUNTY COURT HOUSE Phone 218-739-2271 — Fergus Falls, Mn. 56537 APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY Vs Permit No.LEGAL -3-75Date,DESCRIPTION AND LOCATION Lake No.Lake Name Lake Classif.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: ( ) Masonry ( ) Wood Frame ( ) Structural Steel ( ) Other — Specify ( ) Public ( 1 Individual Septic Tank, etc. WATER SUPPLY: ( ) Public ( . Kfndividual 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. and .......................................feet. Rear yard is feet from septic tank (Sewage System Permit must be obtained before installation), feet from soil absorption system (Cesspool, Orainfield, 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 Surcitarge $. Comments: Form No. MKL-0771-002 1S8899 VICt«M UIHttCCH 4 CO.. MMtTtM. FtRSUB FM.LI. i INSPECTOR'S CHECK LIST Make all measurements and computations ACTUAL IS jr MINIMUMShall Be j Sq. Ft Lot Area (Square feet)Sq. Ft.Sq. Ft. Ft.Water Frontage Ft. Ft.Building Set Back from High Water Mark Ft. 50 Ft.Building Set Back from State Highway Ft. 40 Ft.Building Set Back from Street or Road Ft. Side Yard &Ft.&Ft. Rear Yard Ft.Ft. Occupied Building to Septic Tank 10 Ft.Ft. Occupied Building to Absorption System 20 Ft.Ft. Elevation at Building Line above High Water Mark_____________Ft.3 Ft. Inspector's Comments: ~W~d ( Insnector's Signature Title Inspection Dated Agency VICTOa lUMDCCH t CO . MIHTtM. rCOOUO rALtO. HIMH.