HomeMy WebLinkAbout55000020020005_Variances_11-02-1977f ^ 0 To ^9/xi0PWhite — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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mr.\Street & No.
Owner;Phone No.First Middle
IT J/AOutState^5>r
Zip No.
P^jir.S’ -TiLegal Description: Lake No..Lake Name Lake Class
C .StlenzzknSec.Twp.Range Twp. Name
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If applicant is a corporatiorr,-what state incorporated in____
Applicant is: (|_,LOwner ( ) Lessee ( ) Occupant ( ) Agent
A/a 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
‘i acStI c ;■what Section of the Ordinance:
EXPLAIN YOUR PROBLEM HERE: ^ 7^
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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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Signature ^f i
Application dated.Applicant
—DO NOT USE SPACE BELOW—
19.^:?Jh -- /<ADate application filed with Shoreland Management Administratioa
Deviation requires; Planning Commmission approval ( ) Shoreland Management approval only ( ) Both (
Filing acknowledgement____________
DEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
By
signature
y.\So P 'YD. ^ /TZm .
19____W! TH THE POLL OWINGday of.
\
Signature.^
Chairman
Otter Tall Planning Advisory Commission
Deviation
Approved this day of.19.!. By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tall County, MinnesotaMKL-0871-016
171988-A®
VICT9II LURdItN 00.. fNINTERO. flROUl PALLl. WHIN.
GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
1
‘ 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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1;
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tTTSewage System Permit Number.
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19,Dated.Signature
;On this form make a drawing of your lot. Indicate all present bulldlnga ■ jli
with solid lines and all proposed buildings or additions with dotted - lines. Also Indicate in feetj lake setback, side yard setback end rear i|[U^
yard setback.i
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