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Barcode 128
Ml 1^02^lo.doWhite — Office
Yellow — Owner
Pink -- Township
APPLICATION FOR VARIANCE
FROM
Otter Tail County. Minnesota
erome.^ DI Hi
Last Name I First ros .Phone No.Owner:Middle
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O T\€fi, \/tiLLegal Description: Lake No..Lake ClassLake Name
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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.
19 . X '.dXPyyiji.Application dated.
Signati^e of Applicant
—DO NOT USE SPAOe BELOW—
M.19.TimeDate of hearing
Court House, Fergus Falls, MN. 56537
1st April 19 WITH THE FOLLOWINGday of_DEVIATION APPROVED this______
{OR A TTACHED) REOUIREMENTS:
Approved subject to all other ordinances and regulations. New structure to be
built on present foundation, with garage situated so as not to open onto highway.
Old structures to be removed by the time new house is constructed.
Signature,
[Review ..mi lake. Minnesota 9^3
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ornoffice of Cssu^^y
CoBafy off Ofie? Teli
I hereby certify that lay ^ritbin instru
ment was is tbs offi^ for record
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GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
.19.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.
19
Sewage System Permit Number.
19Dated Signature
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