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APPLICAflON FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
T-z-l-TZ-White — Office
Yellow — Owner
Pink — Township
Qi Phone No.Owner:MiddleLast Name First
'7 ^
Street a No.
it Zip No.City State
Q/nCL/y^ Lake ClassLake NameLegal Description: Lake No..
dl.Twp. Name.RangeSec.Twp.
If applicant is a corporation, what state incorporated in____
Applicant is: ( ) Owner ( ) 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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LuAt'mZwhat 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.
9 9!^
. X1Application dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
9 - //Date application filed with Shoreland Management Administration.
Deviation requires: Planning Commmission approval ( )Shoreland Management approval only { ) Both'T~')
ByFiling acknowledgement
Signatu re
T-^x> 7: rSoDate, time and place of hearing
-^2Zl , 19_^yVITH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REOU!REMENTS:
day of_
i
—» LvnUSignature.
F^'ontfc.Alotodt, Piet»IUt;ht
Ottej^ail Planning Advisory Commission
Deviation
Approved this By. //.^rfcoln/K. Lee, Shoreland l^n^femeift Administrator
tter Tall County, Minnesota
day of.
MKL-0871-016
VICTOR LUMOECN t CO.. PRiNTCRt. PCftCUS r&LLS.
159079
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