HomeMy WebLinkAbout32000990316000_Variances_07-21-1976White - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Last Name
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Street & No.
jxm-c.Owner;Phone No.First Middle
fAr\City State Zip No.
a yfli 2o£iCLegal Description: Lake No Lake Name Lake Classi
VQTwp. "ySec.Range Twp. Name.
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If applicant is a corporation, what state incorporated in____
Applicant is; ( •>T5wner ( ) 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:
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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.
/Z9>6=> .X19.Application dated.T T Ful’e of Applicant
— DO NOT USE SPACE BELOW—
19_^<o
Date application filed with Shoreland Management Administration.
Deviation requires; Planning Commmission approval ( ) Shoreland Management approval only ( ) Both {i^--------
Filing acknowledgement By
Signature
F.F. ,Date, time and place of hearing ■Y
DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day of_, 19 '' 0~WnH THE FOLLOWING
/irFtlT)kEjECTED By
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Dated:
Signature
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19.. By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871 016
171988-A®
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Scale: Each grid equals _j2i_
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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.
GRID PLOT PLAN SKETCHING FORM.feet/inches.
.19.!
19
Sewage System Permit Number.
19___.Dated Signature
Indicate all present buildingsOn this form make a drawing of your lot. with solid lines and all proposed buildings or additions with dotted
Also Indicate in feet; lake setback, side yard setback end rear
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•lines.
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