HomeMy WebLinkAbout22000130099006_Variances_06-20-1973White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Phone No.Owner:
iddleFirst
AJ.n.,r ZipTJoStateStreet & No.
Range___^3__
c.nLake No. ~ ^ ^ 7 Lake NameLegal Description;Lake Class
A3 A3Y Twp. Name.Sec.Twp.
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If applicant is a corporation, what state incorporated in____
Applicant is: (t^Owner ( ) Lessee ( ) Occupant ( ) Agent
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YOB or no
List Partner's name and address below:Is Applicant a partnership.
NAME, ADDRESS AND ZIP NO.NAME, ADDRESS AND ZIP NO,
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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:
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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.
STgTl^njreof ApplicantA19 >~3 .Application dated.
—DO NOT USE SPACE BELOW—
c> -/19^
Date application filed with Shoreland Management Administration.
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only { ) BotTTt^)
ByFiling acknowledgement Signature
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, 19 "7^!TH THE FOLLOWING
C y: ^ oDate, time and place of hearing
A? ADEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day of_
Prank-Alotadt} PresiUei^
Otter Tail Planning Advisory Commission
Signature.io
57-Deviation
Approved this rT,<^1 'xnday of.19( jLW-C a.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
159079
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GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
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.
.19.
.19
Sewage System Permit Number.
19.Dated.Signature
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