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g~l 4PRXLWhite — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Zip No.City StateStreet & No.
C2sd> 'R Lake Name Lake ClassLegal Description: Lake No.
J ^Range Twp. Name.Sec.Twp.
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If applicant is a corporation, what state incorporated in____
Applicant is: ( iJ.-OWner ( ) Lessee ( ) Occupant
i
( ) Agent
List Partner's name and address below:Is Applicant a partnership.‘r, ,yes or no
NAME, ADDRESS AND ZIP NO.
INAME, ADDRESS AND ZIP NO.I
This application for deviation is from Shoreland Management Ordinance, Otter Tail County, Minnesota for conditons found in
what Section of the Onfinance: ^ ^
EXPLAIN YOUR PROBLEM HERE: 0 h J 1
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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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^gnature of Applicant
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Application dated.
—DO NOT USE SPACE BELO'
19___Date application filed with ShorCland Management Administration.
Deviation requires: Planning Commmission approval ( )Shoreland Management approval only Both ( )
ByFiling acknowledgement Signature
Date, time and place of hearing
79____WITH THE FOLLOWINGday of_DEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
Signature.
Frank Alstadt, President
Otter Tail Planning Advisory Commission
Deviation
Approved this eP ZTX
19JZZ: Byday of.X-'Z '/ ft.____—Atafco/m K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL0871-016
159079
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