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\ol2i\i^ns<5^ S',White - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
. Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Owner:Phone No
Last Name First Middle
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Street & No.City State Zip No.
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RD<Tr / PLegal Description: Lake No..Lake Name Lake Class
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RangeSec.Twp. Nama
If applicant is a corporation, what state incorporated in____
Applicant is: ( ^XJwner ( ) 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
T/^iOZ-iG 5what 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.
i2 .19.Application dated.
Signature of Applicant
— DO NOT USE SPACE BELOW—
Date application filed with Shoreland Management Administratioa 19___
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )Both ( )
Filing acknowledgement By Signature
Date, time and place of hearing J
DEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
day of.19____WITH THE FOLLOWING
Approved 45' from driving lane, or sufface of road, provided driveway is
constructed as per drawing with parallel entry to garage./b-Yi,
P^AyYvojt: A-a^ cwvjlA, •
Signatu / Chairman
Otter Tail Planning Advisory Commission
ST'Deviation
Approved this oil (Set.19^
Malt^lm^^Lee, STioreland lClanagemer4r*Administrator
OXXfr Tail County, Minnesota
day of.. By,
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171988-A®
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