HomeMy WebLinkAbout16000990687000_Variances_05-01-1974White - Office
Yellow — Owner
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Pink, —^Township
SS 7~^,5V^yjju^KAjuc>Phone NoOwner;MiddleRrstA Last Name
State
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City Zip No.Street 8i No.
Lake ClassLegal Description: Lake No..
jSC Range Twp. Name,Twp.Sec.
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If applicant is a corporation, what state incorporated in
ApplicantTsT^J) Owner ( ) Agent( ) Occupant( ) Lessee
yes br no
NAME, ADDRESS AND ZIP NO.
List Partner's name and address below:Is Applicant a partnership.
NAME, ADDRESS AND ZIP NO.
application for deviation is from Shoreland Management Ord^anc^Otter Tail County, Minnesota for conditons found inThis
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what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:
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In ord^to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
, X19.Application dated.
Signature of Applicant
— DO NOT USE SPACE BELOW—
4'/oDate application filed with Shoreland Management Administratioa
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) BotRT^
ByFiling acknowledgement Signature
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Date, time and place of hearing
., 19 M//tH the FOLlowingday of_DEVIATION APPROVED this
(OR ATTACHED) REQUIREMENTS:
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Signature.
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Otter Tail Planning AdvisoFy Commission
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Malcolm K, Lee, Shoreland Management Administrator^O|,.«^^-
Otter Tail County, Minnesota
c/Deviation
Approved this 3'"Vna 19day of.9MKL-0871-016
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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.
GRID PLOT PLAN SKETCHING FORMinches.
.19,
.19
Sewage System Permit Number.
1
19.Dated.Signature
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