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APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
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Township
Al -1 90'^c>i'COwner:Phone No.V
Last Name First Middle
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Zip No.City 'Street & No.State
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Legal Description: Lake Na Lake Name Lake Class
.JJ.L25_UoSecTwp.Range Twp. Name
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If applicant is a corporation, what state incorporated in____
Applicant is: ( ) Owner ( ) Lessee ( ) Occupant ) Agent
/1/b 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
nr II cl j: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 proper;^ etc. -4^ (UJ^
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Application dated.
—DO NOT USE SPACE BELOW—
2CDate application filed with Shoreland Management Administratioa 17 Both ( )Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )
Filing acknowledgement By Signature
l/^V) ,Cjb^Aj. cDate, time and place of hearing ^ — ^ >-v»
day of'19l^ WITH THE FOLLOWINGDEVIATION APPROVED this______
(OR ATTACHED) REOUIREMENTS:
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Chairman^
Otter Tail Planning Advisory Commission
Signature f
Malcolm K. Lee, Sh^eland Managemenf'AdminjsHatorj
Otter Tail County, Minnesota O
Deviation
Approved this A i9_^lT Ry yy^a.Tu^.■SbS^day of.
MKL-0871-016
171988-A®
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