HomeMy WebLinkAbout16000990651000_Variances_08-01-1973White - 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
fepy; ^7?l-Lrrujuj,
State Zip No.Street & No.
sU -£ ?LLegal Description: Lake No..Lake Name Lake Class
Range Twp. NamaSec.Twp.
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If applicant is a corporation, what state incorporated in
Applicant isri-|^0 ( ) Agent( ) Occupant( ) Lesseewner
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 conditonsfound in
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what Section of the Ordinance:____
EXPLAIN YOUR PROBLEM HERE:7^ '
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
r/ ^Application dated.
—DO NOT USE SP
r-/jTDate application filed with Shoreland Management Administration.
Deviation requires; Planning Commmission approval ( ) Shoreland Management approval only ( )B^tfiV )
ByFiling acknowledgement
_ « Signature
7: £o
____C=7
Date, time and place of hearing T
., 19 P^WITH THE FOLLOWING(pa/DEVIATION APPROVED this
iOR ATTACHED) REQUIREMENTS:
day of_
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Otter Tail Planning Advisory Commission
Signature.
Deviation
Approved this day of.Malcolm K. Lee, Shoreland Management Adn^jstrator
Otter Tall County, Minnesota jOMKL-0871-016
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159079
Sc^te: Each grid equals
Application for Building Permit Dated
GRID PLOT PLAN SKETCHING FORM
Application for Sewage System Permit Dated.
Building Permit Number_________________
Applicant agrees that this plot plan is a part of application (s) indicated above.
Sewage System Permit Number.
Dated
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