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Barcode 128
White - Office
Yello'*' Owner Pin'
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Township
Last Name ^
Street & No.
u>iz-
State ZiiS No!
Phone No.Owner:
MiddleFirst
City
Legal Description; Lake No..Lake Name Lake Class
~ yVJlyL^
Twp.Twp. NameSec.
JkocJl—
If applicant is a corporation, what state incorporated in____
Applicant is: ( ) Owner ( ) Lessee (tXTccupant
■*
( ) 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 C^nty, Minnesota for conditons found infrprf?
what Section of the Ordinance:
EXPLAIN YOUR PROBLEM HERE:
(SAJlXA'-P-- . Vi) ^ 4) ^
In order to properly evaluate the situation, please provide as much supplementary informa
plans, information about surrounding property, etc.
. maps.
uCXj,19.. XApplication dated.V Signature of Applicant
—DO NOT USE SPACE BELOW—
4-
19___Date application filed with Shoreland Management Administration_____________^__________________
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )Both ( )
Filing acknowledgement By Signature
Date, time and place of hearing
DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
19____W! TH THE POLL OWINGday of.
Signature.
Frank Alstadt, President
Otter Tail Planning Advisory Commission
Deviation
Approved this 192^
_____________________________M^tcrflm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaTday of.
MKL-0871-016
VICTO* CUMOECM 4 CO . »*INTC4t. 4t*«U4 TALLl
159079
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White - Office
Yellov«»— Owner
Pink*— Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota■
Phone NoOwner:MiddleLast Name First
i
Zip No.City StateStreet & No.
1 ■I
Lake Name Lake ClassLegal Description: Lake No..
Twp. Name.Sec.Twp.Range
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:
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.. XApplication dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
19___Date application filed with Shoreland Management Administration________________________________
Deviation requires: Planning Commmission approval { ) Shoreland Management approval only ( )Both ( )
ByFiling acknowledgement Signature
Date, time and place of hearing
19____WITH THE FOLLOWINGDEVIATION APPROVED this______
(OR A TTACHED) REOU!REMENTS:
day of_
t
OJC^
r
Signature.
Frank Alstadt, President
Otter Tall Planning Advisory Commission
Deviation
Approved this 19day of.■ By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, Minnesota
MKL-0871 016
159079
VICTO* LUHBCCM « CO PRiMICa*. rc*cus rttkl.