HomeMy WebLinkAbout22000990472000_Variances_07-06-1976White — Office
Yellow — Owner
"Pink — Township
APPLICATION FOR VARIANCE
FROM
Reauirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Last Name jf U First Middle \
Street & No. City State
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Owner:Phone No
zip No.
Lake No.Legal Description:Lake Name Lake Class
Twp.ILSec.Range Twp. Nama
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If applicant is a corporation, what state incorporated in____
Applicant is: ( ) Owner ( ) Lessee ( ) Occupant ( ) Agent
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
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.
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Application dated.Sngnatu Ap/fii
Date applic^on filed with Shoreland Management Administration.19___
I..,- Both ( )Deviation require^Planning Commmission approval ( ) Shoreland Management approval only
Filing acknowledgement By
igna-ture
Date, time and place of hearing
DEVIATION APPROVED this
(OR A TTACHED) REQUIREMENTS:
day a , 19____WlTH THE FOLLOWING
Signature
Chairman
Otter Tall Planning Advisory Commission
* Deviation
Approved this day of.19 . By.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
171988-A(S^ vicTON LUH9CCN CO.. POINTEM. PCROUO fALU. UIMN.
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DAVID R. RETZLAFF, Special Representative
Insurance Savings
404-E Gustavus Ave.FrsiiKLiorgus Falls, Minn. 56537 LIFE INSURANCE COMPANYPhone: 739-.9491 JJP«INGFi£LD. JtL(NO;S 62713
=H0NE= 217-528-2011•“-V
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