HomeMy WebLinkAbout39000990320000_Variances_06_05_1974• -»
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 MiddleFirst
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'^ip No.Street & No.City State
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G -0■5. Li JaS1-7V7Legal Description: Lake No..Lake Name Lake Class
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Sec Twp.Range Twp. Name.
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If applicant is a corporation, what state incorporated in____
Applicant is: (i,X)wner ( ) 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 conditons found 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.
Signature of Applicant
19.Application dated.
—DO NOT USE SPACE BELOW—
19.^^S '<2^Date application filed with Shoreland Management Administration
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) BofFTf»J )
ByFiling acknowledgement Signature
Date, time and place of hearing ^'U\x\. esipe^i
„ 19 WITH THE POLL OWINGDEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
day of_
Signature.
Frank Alstadt, President
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19 . By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
VICTOI LUNOtCN A CO.. OKiNTCia. FtMUS FALLS.
159079
GRID PLOT PLAN SKETCHING FORM.feet/inches.
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.
■ Scale: Each grid equals
.19.
.19
Sewage System Permit Number.
.19.Dated.SignatureI
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