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YeTiow“-°own\r APPLICATION FOR VARIANCE
Pink — Township FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Owner:.
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JlasX Name
A
First Middle
Phone No,
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Street & No.
j.------
City State
Lake Name.Legal Description: Lake No.. W_.
6j?e Sec. Twp. /3 S____ Range------iSSL
Zip No.
Lake Class.rr<D
Twp. Name_
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2<ai.Xe ^^ior-h
If applicant is a corporation, what state incorporated in-----------------------------------------------------------------—-------------—
Applicant is: (c/TOwner ( ) Lessee ( ) Occupant ( ) Agent
Is Applicant a nartnprship OO_______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
h)f>. ^
9S'
what Section of the Ordinance:________
EXPLAIN YOUR PROBLEM HERE:
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do/c2e. /ci ^
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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.
Deviation requires: Planning Commmission approval
Filing acknowledgement__________________________
Shoreland Management approval only (
_ By___________
Both
Signature
Date, time and place of hearing —
___DEVIATION APPROVED this_____
(OR ATTACHED) REOUIREMENTS:
day of niJiJLrs19 7^ INI TH THE POLL OWING
Deviation
Approved this.
MKL-0871-016
VICTOt LUNOCCN ■ CO. MIH
i 5'. day of_
I 159079
Signature _ ^3* O ^
rrank Alotadf; Preaietent t/Vv^W
19.7^
. By-
Otter Tail Planning Advisory Commission
Malcolm K. Lee, Shoreland Management^dminj^trator
Otter Tail County, Minnesota
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