HomeMy WebLinkAbout08000340251000_Variances_05-07-1975White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreignd Management Ordinances Otter Tail County, Minnesota
PoAOwner:Phone No
Last Name First Middle
i)Hy?hnIGVtfs Quo
Street & No.State Zip No.
cy^/|L ake Class £ALegal Description: Lake No..Lake Name
Sec. ^ 4'0!cOi^d^^74/Twp.Range Twp. Nama
/<^C> dC.4ji>o
If applicant is a corporation, what state incorporated in___
Applicant is: ( |,K5wner ( ) 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 Or^^nce^tter Tail County, Minnesota for conditons found in
what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:i-f o''7C Yoo' (p u„OYU:^jc7' /O—
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In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
4~f(19 . XApplication dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
Date application filed with Shorfiland Management Administratioa
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) Both
Filing acknowledgement By Signature
3^ 7-y^ P. yn, /?7-
/T /T YXxpi.Date, time and place of hearing CruuxX.
DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day of_, 19____WITH THE FOLLOWING
REJECTED Ey Citfabv</^ooJ^ 0:wYcb^
13J^ Initials POd
yjLfiA)
Dated:I i/a-£L
Signature
Chairman
Otter Tall Planning Advisory Commission
Deviation
Approved this day of.19 ■ By.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
171988-A®
VICTOR UiNDCiN 00.. RRINTIRI. riROUl fM.Lt. HIMR.
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 No,.LEGAL
. ^Date.DESCRIPTION
AND
____________/ruJUt/f
<£*■ /-)
LOCATION
^4/
TWP NameTWPRangeSec.Lake Classif.Lake NameLake No.
IDENTIFICATION: Please Print All Information
Tel. No,Zip No.Mailing Address— No. Street. City and StateInitialFirstL^ Name
illOwner T(5I
NameContractor
Architect Name.
NON-RESIOENTIAL PROPOSED USE:RESIDENTIAL PROPOSED USE:TYPE OF IMPROVEMENT:
Specify:.( ) One Family Dwelling
( ) Multiple Dwelling
(yf^her
( ) New Building
( ) Alteration
( tXl^her______
Units
I/Vox fO o /Size
ESTIMATED COST OF IMPROVEMENT $(omit cents)
DIMENSIONS:TYPE OF SEWAGE DISPOSAL:PRINCIPAL TYPE OF FRAME:
Basement: ( ) Yes ( ) No
Stories above basement:
Sq. feet (outside dimension)
Bedrooms
( ) Masonry
( ) Wood Frame
( *fStructural Steel
( ) Other — Specify
{ ) Public
( ) Individual Septic Tank, etc.
WATER SUPPLY:
( ) Public
( ) Individual Well
MECHANICAL EQUIPMENT :
Elevator: ( ) Yes
Air Conditioning: ( ) Yes
( ) Central
±OQO.....
Baths
HEATING:
( ) Electric I ) Gas
I ) None
( ) Oil( ) NoType of Roof:
( ) No ( ) Coal
Other:( ) Unit
CHARACTERISTICS:
^.Q.Q.!C...C^m.Q......feet.
square feer.Water frontage isLot 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 is........................
Side yard is....................
Building will be located
Building will be located
■feet
feet.feet — from road or street is
.......................................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.and
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
State Surcharge $.Permit Fee $.
Comments:
Form No. MKL-0771-002 1S8899
VICT9I tUVeiCH 4 M.. MUHTf«a. VEB4U4 FM.LI. MIHN
--+-t GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
Application for Building Permit Dated.
Application for Sewage System Permit Dated
Building Permit Number_________________
Applicant agrees that this plot plan is a part of application (s) indicated above.
.19.
.19
Sewage System Permit Number.
|2W£-JUL19.Dated Signature
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