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White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Last Name First Middle
9/y CLy^.X. '^nbuqx-)
Street & No. Citjf
Phone'Owner;
n.o oy/na.State Zip No.
Ahhn 4h!J-3l<4- 1Legal Description: Lake No..Lake Name Lake Class
z02iSec.Twp.Range Twp. Name
If applicant is a corporation, what state incorporated in____
Applicant is: ( i+'Owner ( ) Lessee ( ) Occupant ( ) Agent
List Partner's name and address below:Is Applicant a partnership
yes or no
NAME, ADDRESS AND ZIP NO.NAME, ADDRESS AND ZIP NO.
This application for deviation is from Shoreland Management Ordinance, Otter Tail County, Minnesota for conditonsfound in
what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:
X 3X
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
19.Application dated.. X
Signature of Applicant
—DO NOT USE SPACE BELOW—
Date application filed with Shoreland Management Administration.
Both Kx/'
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )
Filing acknowledgement By
Signatu relicT'lUi 9. fh. ^ 0 irlcFLKXlJL ^ . J ^Date, time and place of hearing
DEVIATION APPROVED this____________
(OR A TTACHED) REQUIREMENTS:
By
day of_19____WITH THE FOLLOWING
/Y7yyp/nAlAy~x^ .
, iWtials
J)0(xdi I
Dated:
Signature
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19 ■ By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
171988-A®
VIGTOM UfN»eCN M.. PltMTIM. riK«UI rM.Lt. HINN.