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White — Office
Yellov^— Owner Pink
APPLICATION FOR VARIANCE
: J^ovYnship FROM
t Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Owner
Last Name First
o
Middle
Phone No. ~ ^9^ 9
t)i^ ptNe /-A^Ae____
7 / Street & No. City^/IL N /V.State ..S'7A
Zip No.
Legal Description: Lake No.
Sec____
5^. ___L. ____ Lake Namet~f N Lake Class_____^ ^^
^2-____ Twp.__/ ___ Range___3£_____ Twp. Name tiHti. l~’hK&
CtLt !/ 2.0 I j A dJj2.<■*/ j
If applicant is a corporation, what state incorpiorated in____
Applicant is: ()fy Owner { ) Lessee ( ) Occupant
Non
Is Applicant a partnership_No’
yes or no
NAME. ADDRESS AND ZIP NO
/4v>/<
( ) Agent
List Partner's name and address below:
_ 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:.___
EXPLAIN YOUR PROBLEM HERE.
/7c
CC-^
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps.
plans, information about surrounding property, etc.PdL*-C_ • 3^ XipS^ ^ ^ ^/7> 0 0 ><2-a 0-^9 /tij) p
^ of(2^A ^^ooo fyy-- Uo-i^o^ 7“"^ H a 7)v,,.a/£^
ited 7 7 19______________ . X 2o/Y!u:r. <^ (U _______Ap|^icatio|t dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
Date application filed with Shoreland Management Administration.
^ ig/y^
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) Both {
Filing acknowledgement By
Date, time and place of hearing.
DEVIATION APPROVED this
Signature
^ __T'jSg_, /CVr Y>tr\ -
fV/TH THE FOLLOWING '. day of_19_
(OR ATTACHED) REQUIREMENTS:
OXrM^Ci b«^CCUUL:X^ --L't OUd r\Oi. nr-^Zt-X ^XrhJL^
ty~\(^ir\i rr-^ LAJ-^^ "3)0,000 CXX
uu rcnr^cni
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this.. day of.19... By.
MKL-0871-016
171968A® viCTOH u/NpccN eo.. PHiMTcat. rcRiup r«LL«. mihn.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County. Minnesota
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