HomeMy WebLinkAbout13000990336000_Variances_06-23-1972White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Last Name
Phone NoOwner:MiddleFirst
A!•cit^a).StateStreet & No.Zip No.
frOLegal Description: Lake No..Lake Name Lake Class
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Twp.RangeSec.Twp. Nama
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If applicant is a corporation, what state incorporated in____
Applicant is: (l-pOwner ( ) Lessee ( ) Occupant ( ) Agent
/10 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
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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.
19.Application dated.
—DO NOT USE SPACE BELOW
Date application filed with Shoreland Management Administration.
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )Both ( )
- ByFiling acknowledgement Signature
Date, time and place of hearing
19____WITH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
day of.
Signature.
Frank Alstadt, President
Otter Tail Planning Advisory Commission
Deviation
Approved this 19day of.. By.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
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S-GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
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.
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Sewage System Permit Number.f
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.19___.Dated,■t '1Signature
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