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APPLICATION FOR VARIANCE
FROM
OTTER TAIL COUNTY, MINNESOTA
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IS.nnApplication Fee $
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Last Name First f
Street & No. City
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Owner: /Phone:
Middle
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State Zip No.
'5^6? CyLake No.Lake Name Lake Class
koSec.Twp.Range Twp. Name
Legal Description:
Pt. /U, iSo'of EILO
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Lot No.Block No.
Sub-Division Name:
Parcel Number
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. APPLICIANT SHALL BE PRESENT AT THE SCHEDULED HEARING.
Signati/re of Applicant
7—^jApplication dated.19.. X i
— DO NOT USE SPACE BELOW—
Date of hearing 19.Time M.
Court House, Fergus Falls, MN. 56537
DEVIATION APPROVED this_____
(OR ATTACHED) REQUIREMENTS:
day of_19____WITH THE FOLLOWING
Signature:
Chairman
Otter Tail Board of AdjustmentMKL 0483 -001
215601®
VICTOM LUNOEEN CO . PKiNTEKt. FERGUS ‘«LL8. UINN.
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Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORMr
Dated:• - t -4
Signature
Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently
on lot and any proposed structures.
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21598 7®MKL-0871-029
VICTOR LUNOeCN CO.. PRINTERS. FERGUS FALLS.
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Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM
19 \Dated:C Signature
Please sketch your lot indicating setbacks from road right-of-way, lake and sideyard for each building currently
on lot and any proposed structures.
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21598 7®MKL-0871-029
VICTOX LUHDEEN CO . PRINTERS. ECRSUS FALLS. MiNN.