HomeMy WebLinkAbout16000990459000_Variances_09-01-1976White - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
, FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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T_ast Name IOwner:Phone No.First Middle
Mrv sStreet & No.City State Zip No.
__ Lake Name ^ ^ t j. Lake Class
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Ci lo~ 3 ^ ^Legal Description: Lake No..
yj.Sec.Twp.Range Twp. Nam&
C ry 5 Aci )
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 Tall County, Minnesota for conditons found in
J n.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.
n Signature of Applicant
19 't^L, . XApplication dated.
—DO NOT USE SPACE BELOW—
^ -aoDate application filed with Shordland Management Administratioa
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) Both (
Filing acknowledgement By
Signature
Date, time and place of hearing ^ ~ 1 ~7‘3Qp.i<yv,
day of__
57^^_WITH THE FOLLOWING/DEVIATION APPROVED this______
iOR ATTACHED) R^UIREMENTS:
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Chairman
Otter Tail Planning Advisory Commission
Signature
c/Deviation
Approved this
/->19_&. Bv-day of S
Malcolm K. Lee, Shoreland Management Admin^rato^
Otter Tail County, Minnesota ''vMKL-0871-016
171988-A®
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GRID PLOT PLAN SKETCHING FORM
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.
shale: £ach grid equals .feet/inches.
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Sewage System Permit Number.
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i19.Dated.Signature
On this form make a drawing of your lot. Indicate all present buildings
with solid lines and all proposed buildings or additions with dotted
— Also indicate in feetj lake setback^ side yard setback and rear
:z yerd setback.
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