HomeMy WebLinkAbout37000990409000_Variances_02-04-1976White - Office
Yellow — Owner
Pink — Township
A ^APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Owner:Phone No
Last Name First Middle
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Street & No.City State Zip No.
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IA r^nV)Legal Description: Lake No.
Sec. 5
Lake Name Lake Class
jL><Acl/3LTwp.Range Twp. Name.
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If applicant is a corporation, what state incorporated in__________________
Applicant is: ((J^wner ( ) Lessee ( ) Occupant ( ) Agent
List Partner's name and address below:Is Applicant a partnership
yes or no
NAME, ADDRESS AND ZIP NO.t?NAME, ADDRESS AND ZIP NO.
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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:
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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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19 PiT' .XApplication dated.
e of Applicant
—DO NOT USE SPACE BELOW—
-/cPDate application filed with Shorfiland Management Administratioa 19
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) Both'V')
Filing acknowledgement______
6afe, time and place of hearing
By Signature
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, 19____W!TH Tt^ POLLOWINdDEVIATION APPROVED this.______
(OR ATTACHED) REOUIREMENTS:
day of_
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____
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®
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GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
.19.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
Sewage System Permit Number.
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19,Dated
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