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APPLICATION FOR VARIANCE
FROM
• -• Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Owner: 4-b.)j-~ lllma ,
Last Name First Middle 11~;3 Ai&,~,. K /1),'I)~ 1>1"\,-
• Coty State Street & No.
Legal Description: Lake No. bfc,-,11/ / i Lake Name £ ~
13.S-Range _ __._.3""'""'( __ Sec. .;)_ / Twp.
Phone No. 3%S--..73Q/
Zip No.
Lake Class _ __,,G~-=o~~----
Twp. NamP~ _ _,C)_=,¼ ........ __. ____ _
If applicant is a corporation, what state incorporated in ________________________ _
Applicant is: ( l,).-0wner ( ) Lessee ( ) Occupant ( ) Agent
Is Applicant a partnership, ___ //~O"--__ List Partner's name and address below:
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
what Section of the Ordinance: _____ ~_,__.,.~h-c-.b .... (!3. ____ # _ _.,.5:-~-------------------
EXPLAIN YOUR PROBLEM HERE:
;,?ob., le 1/~e p)4~cl
J,-"'e_ C)-1'\., co" l"i. SA.etu..Jcl 6_ /
~i I\;, bod,1 o+ /1?ob~1e, 1/o--ie, .,'-5 01.Je-r ~ 1 {,~
PT"l!)eerfy ),· t> e, b~ I: f ,:a -cu f ; !2 Cn'2~ .:i. ~ 1
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
Application dated ___ ?_.L./2_,~=----=------19_23 . x ~ ~ ;27/-,~
Signature of Applicant
--DO NOT USE SPACE BELOW--
Deviation requires: Planning Commmission approval ( Shoreland Management approval only (
Filing acknowledgement _____________ _ BY-------,,.,---,-------------p Signature
Date, time and place of hearing ~z_-_l_-_7_S~G)~ __ 7-'---·~~0<--'o=-----'-·-'-!>{--=....,',-"'G ......... t> ..... ,Jt:li ...... ""'-A-W..Ou.¥--~=--, ........... F_,_ . .,_f:.,_. -4-'~'-=-"~
DEV/A TION APPROVED this ____ ...,.~....,,__,lt...,,d-"-'-_day of ~ /
(OR ATTACHED) REQUIREMENTS: f , 19~WITH THE FOLLOWING
~rm/~ ~ o;'.,.,e£/
lna,/1 ~e,,;-t-.
s;gnatu" ,&~ ... .l~ .. -~ M,
Otter Tail Planning Advisory Commission
Deviation
Approved this_~c{l_~/L~J __ day of ~(,.L,C>:f":
MKL-0871-016 (j
rnK . sy 'fttJ:ob / ~.£<--
Ma1co1m K. Lee, Shoreland Management Adm.inisubtor
Otter Tail County, Minnesota C..,,,,-,.0
Scale: Each grid equals _____ feet/inches . . ,-,~
GRID PLOT PLAN SKETCHING FORM
' A~plication for Building Permit Dated ________ 19 __
Application for Sewage System Permit Dated _______ 19 __
Building Permit Number _________ _ Sewage System Permit Number ___ --'------'-----
Applicant agrees that this plot plan is a part of application (s) indicated above.
Dated X~
'-'"
0 1
f
MKL-0871 -029 1591()4 @ 'l'ICTOlt LNIIOUII ' co .... ,11.nu r(HUI , ....... 11111111