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"1White — Office
Yellow — Owner
APPLICATION FOR VARIANCE
FROM
* Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Pink — Township
£JL MyPhone NoOwner:MiddleFirstLast Name
Street & No.
Lake ClassLake NameLegal Description: Lake No.
ru^Twp. Name.RangeTwp.Sec.
If applicant is a corporation, what state incorporated in
Applicant is: (^.^wner ( ) Agent( ) Occupant( ) Lessee
List Partner's name and address below:Is Applicant a partnership.
yes or no
NAME, ADDRESS AND ZIP NO.NAME, A»»RESS AND ZIP NO.
This application for deviation is from Shoreland Management Ordinance, Otter Tail County, Minnesota for conditonsfound in
Icf '
what Section of the Ordinance:_____
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.
Signature of Applicant
Application dated.
—DO NOT USE SPACE BELOW—
^7
------c--------7^19.2.2—Date application filed with Shoreland Management Administratioa
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )Both
By.Filing acknowledgement Signature
zyJ'CDate, time and place of hearing
JL/. 19_^W!TH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day oT ¥■
A ,/l _ySignature.
Fmnlf i^h'lmrtT. Pracirirnt
OtterTail Planning Advisory Commissid
Deviation
Approved this Jr. z 19_^ By.. f ________Malcoirn K. Lee, Shorelana Man^ement Administrator
Otter Tail County, Minnesota
day of.rMKL0871-016
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