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APPLICATION FOR SPECIAL USE PERMIT
Shoreland Management Ordinance
Otter Tail County
Fergus Falls, Minnesota 56537
White — Office
Yellow — Applicant
oo3 19 Application Fee $ ^6Date Permit No.
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Legal description of land: Lake No.jzS^^l— Sec. <a?
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Range _s3_2_ Twp. Name¥Twp.
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Sketch and supporting data submitted,
PROPOSED USE OF LAND:
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P 3 ir\ fistg,A.AddressApplicant.
Applicant Signature -76/-
Home Phone Bus. Phone,
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Tr^'-Oo mDate of Hearing Time.
CONDITIONAL REQUIREMENTS:
This application is hereby recommended for approval by the Otter Tail County Planning Advisory Commission.
Chairman
Approved by the Board of County Commissioners of Otter Tail County this.day of..19
Chairman
Special Use Permit issued in accordance with compliance with existing Conditional Requirements and Special Regulations and
Minnesota Commissioner of Natural Resources notified this day of 19,
SPECIAL USE PERMIT NO.
Malcolm K. Lee, Shoreland Administrator
Otter Tail County, Minnesota
MKL-0871-010
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