HomeMy WebLinkAbout37000040026002_Variances_06-06-19731
White - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Last Name
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Phone NoOwner;MiddleFirst
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State Zip No.
^ I / nLake Name Lake ClassLegal Description: Lake No
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If applicant is a corporation, what state incorporated in____
Applicant is: (t-TOwner { ) 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
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what Section of the Ordinance:
EXPLAIN YOUR PROBLEM HERE:
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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.
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Signature of Applicant
21 .X19.Application dated.
— DO NOT USE SPACE BELOW—
19.^Date application filed with Shoreland Management Administratioa
Deviation requires; Planning Commmission approval ( ) Shoreland Management approval only ( )BotFTf )
- ByFiling acknowledgement
SIgnatu re
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Date, time and place of hearing
6 ^DEVIATION APPROVED this
(OR ATTACHED) REQUIREMENTS:
day of_
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l^ronh Alatodti Proaident ^
Otter Tall Planning Advisory CofmnIsslOT
Signature.
Deviation
Approved this
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Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, Minnesota
day of.
MKL-0871-016
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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.
19.Dated
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