HomeMy WebLinkAbout57000010002003_Variances_06-06-1974OU)|ou)\vcn^White — Office
Yellow^- Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Phone NoOwner:MiddleLast Name
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Street & No. 7 City Zip No.State
it f JLegal Description: Lake No.,Lake Nam
I 113.Twp. Name.Twp.RangeSec.
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If applicant is a corporation, what state incorporated in____
Applicant is: (“ftSwner ( ) 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 conditonsfound in
what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:I
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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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} 7 Signature of y^^plicantr-nApplication dated.
—DO NOT USE SPACE BELOW—
id19Date application filed with Shoreland Management Administration.
Deviation requires: Planning Commmission approval ( )Shoreland Management approval only ( ) BotfTN )
ByFiling acknowledgement Signature
Date, time and place of hearing P •
DEVIATION APPROVED this day of ^ OUaji.19 74 WITH THE FOLLOWING^ ^^1^
(OR A TTACHED) REQUIREMENTS:
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Signature,
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Otter Tail Planning Advisory Commission
Hno oAol ^rfc^4;eviation
'(proved this 74 By-y Ua^ 19day of.Malcolm K. Lee, Shoreland ManagemefttjA^mfnistrator
Otter Tail County, Minnesota:J-0871 -016MK
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Scale: Each grid equals_s5^GRID PLOT PLAiM SKETCH I MG FOhiVl.feet/inches‘
Application for Building Permit Dated,.19.
Application for Sewage System Permit Dated 19
Building Permit Number.Sewage System Permit Number.
Applicant agrees that this plot plan is a part of application (s) indicated above.
19____Dated.
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%GRID PLOT PLAN SKETCHING FORM.feet/icwtessr' Scale: Each grid equals
^ Application for Building Permit Dated_____
»Application for Sewage System Permit Dated
.19.
.19
Sewage System Permit Number.Building Permit Number
Applicant agrees that this plot plan is a part of application (s) indicated above.
.19___.Dated.
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