HomeMy WebLinkAbout13000990409900_Variances_06-07-1972White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Last Name
9-.?'.~73f- 9y/aPhone NoOwner:MiddleFirst
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Street & No.City State Zip No.
sc-c ^Legal Description: Lake No.Lake Name Lake Class
)Cc3/ ? ^ RangeSec.Twp.Twp. Nama j A
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If applicant is a corporation, what state incorporated in____
Applicant is: { ) Owner ( ) 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:
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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.
/y Sigrfature of Applicant
igJZlk .Application dated.
—DO NOT USE SPACE BELOW—
ISZjr'7- ^Date application filed with Shoreland Management Administration
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) Both
Filing acknowledgement
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By
Signature
li': /7*/jDaTSTflifte add place of hearing
■T»-7 19 ^ WITH THE FOLLOWINGJ Lcz>—<-DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS: r\ ^ f ' n » \
CS^ AJ-P
day of_
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a.rcy^Signature.
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Otter "tall Planning Advisory Commission
Deviation
Approved this day of.19.fue^Shorel^a Management Administrator• BV,MitTc^lm K
Otter Tail County, MinnesotaMKL-0871-016
ViCTOI WUNetCN f C9 PKlNtCHt. rCMCUS r*LI.I. MHIM. 1G0073
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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.
GRID PLOT PLAN SKETCHING FORM.feet/4
i
.19.
19
Sewage System Permit Number.
!I
.19' Dated.
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