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APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Last Nami
C\Phone NoOwner:
F Irst Middle
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State
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Street & No.City Zip No.
£M3<b 0 oveLegal Description: Lake No.'Lake Name Lake Class
2_137Sec.Twp.Range Twp. Name.
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If applicant is a corporation, what state incorporated in____
Applicant is: (Hr'Swner ( ) 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:fTo C-0>-sT^u,c.T CL
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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 ofC^^fl/Hcant
19^^ f' .Application dated
— DO NOT USE SPACE BELOW—V
19!^
Date application filed with Shoreland Management Administration.
Deviation requires; Planning Commmission approval ( ) Shoreland Management approval only ( ) ^oTfrp )
Filing acknowledgement By
signMure
Gc>u>J:ktou^e^ ,r.r.7’.ScDate, time and place of hearing
DEVIATION APPROVED this._____
(OR ATTACHED) REQUIREMENTS:
day of_, 19____W!TH THE FOLLO
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Signature.
Frank Alstadt, President
Otter Tall Planning Advisory Commission
Deviation
Approved this day of.19 . By.Malcolm k. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871 016
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