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White — Office Owner APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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*" Pink — Township
I? ^Phone No.Owner;MiddleLast Name First
State Zip No.CityStreet & No.
\52-2 M3 CUr/ oy\Lake ClassLake NameLegal Description: Lake No..
/ ir HO2_Twp. Name.RangeTwp.Sec.
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If applicant is a corporation, what state incorporated in------
Applicant is: (*H^wner ( ) 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: ^ 0
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ie^truationTpieSe^provfdeasrmichsLWlementary information as possible^such as: maps
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In ordfef to properly evaluate the
plans, information about surrounding prope^^ty, etc.
Application dated
Ignature of Applicant
—DO NOT USE SPACE BELOW—
19___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
!9____\NITH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
day of_
'! .
Signature.
Frank Alstadt, President
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19 • By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL0871-016
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