HomeMy WebLinkAbout53000990404000_Variances_04-25-1974Variances
Barcode 128
White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Phone NoOwner:MiddleLast Name First
JPi
itv sStreet ^fisy.State Zip No.
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jaLake ClassLake NameLegal Description: Lake No
3^IAS-Range Twp. NamaSec.Twp.
7 ^ Ctdo
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 conditons found in
_________________________what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:
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properly evaluate the situation, please provide as much supplementary information as possible, such as: maps.In order to
plans, information about surrounding property, etc.
4 S'Application dated.
ignature of Applicant
—DO NOT USE SPACE BELOW—
4Date application filed with Shordland Management Administration.
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )BoTIHj)
ByFiling acknowledgement Signature
,^—t ~ 74- (A) F sDate, time and place of hearing
\NITH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day of_
0
Signature
mjg•FranU Aletadt, Presidont ,
Otter Tail Planning Advisory Commission
Deviation
Approved this VT)19_7Y By.f oe>e_day of.
Malcolm K. Lee, Shoreland Management Ad^nistra^r
Otter Tail County, Minnesota ■—MKL-0871-016
VICTOR LUNOtCM 4 CO.. RRiNT[R(. FCRBUS rM.Lt.
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.
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Sewage System Permit Number.
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