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Home My WebLink About29000990664000_Variances_10-06-2011Variances 2 Barcode 128 1098648 DOC# 1098648Date Stamp 1098648 Fee: $46.00 Well Certificate [ ] Rec'd OFFICE OF COUNTY RECORDER OTTER TAIL COUNTY, MINNESOTAreceived SEP ^ ^ 2011 LAND & RESOURCE Certified, Filed, and/or Recorded: October 14, 2011 9:45 AM Wendy L. Metcalf, Recorder Returned To: LAND & RESOURCE By: LLL&R Initial THE ABOVE SPACE IS RESERVED FOR THE COUNTY RECORDER APPLICATION FOR VARIANCE COUNTY OF OTTER TAIL GOVERNMENT SERVICES CENTER, 540 WEST FIR, FERGUS FALLS, MN 56537 (218) 998-8095 Otter Tail County’s Website: www.co.ottertail.mn.us Application Fee Receipt Number Accepted By / DateS^^" Dean Jacobson, Jr.; Dean Jacobson,Jr., and Iris A. Jacobson, Trustees or their successors in Trust, under Jacobson Family Revocable Living Trust dated 9-20-07 P.n. Rnv r.1 1 FVig-ral 1 MN COMPLETE THIS APPLICATION IN BLACK INK DAYTIME PHONE 21 8-R64-R950PROPERTY OWNER MAILING ADDRESS RAR9/,-nnnQ 239 LAKE NAME West Battle Lake LAKE CLASS GDLAKE NUMBER TOWNSHIP NAME GirardRANGE 39SECTION 29 & 32 TOWNSHIP 133 000^ ^^~OU>UH~ooo 29-000-99-0665-000 E-911 ADDRESS 41531 Ukkelberg Drive, Clitherall.MN PARCEL NUMBER LEGAL DESCRIPTION Lot 18, Fair Oaks ^7; fk'ttrOakS TYPE OF VARIANCE REQUESTED (Please Check) Subdivision _X__ Cluster WECSSewage System Misc.Structure Setback Structure Size SPECIFY HOW YOUR PROJECT VARIES FROM ORDINANCE REQUIREMENTS. PLEASE BE BRIEF AS THIS WILL BE USED FOR PUBLIC NOTIFICATION. See attached Exhibit A DcJ-ai Is- toouU reject I UNDERSTAND THAT I HAVE APPLIED FOR A VARIANCE FROM THE REQUIREMENTS OF THE SHORELAND MANAGEMENT ORDINANCE/SUBDIVISION CONTROLS ORDINANCE / SANITATION CODE / SETBACK ORDANAND AN/OR WECS ORDINANCE OF OTTER TAIL COUNTY. I ALSO UNDERSTAND THAT OTHER PERMITS MAY BE REQUIRED; IT IS MY RESPONSIBILITY TO CONTACT LAND & RESOURCE MANAGEMENT REGARDING THIS MATTER. 9/15/2011SIGNATURE OF PROPERTY Ot^ER / AGENT FOR OWNER (R. Kristian Svingen,Attorney for Owner) APPLICANT MUST BE PRESENT AT THE HEARING DATE (Applicant Will Receive Notification As To The Date/Time Of Hearing) 345.194 • Victor Lundeen Co.. Printers • Fergus Falls. Minnesota TimeDate Of Hearing Motion Jacobson Family Revocable Living Trust-Appiication approved as requested. (7:58 p.m.) After consideration and discussion, Thomas Lee made a motion, seconded by Steve Schierer and carried with Paul Larson voting no and with Randall Mann abstaining, to declare combined Lots 16 and 17 Fair Oaks as one residential buildable lot and to declare Lot 18 Fair Oaks as a separate residential buildable lot. Those abstaining and voting against the motion to approve noted that the granting the variance is correcting an attorney's mistake and is a self-imposed practical difficulty. Those supporting the motion to approve noted the documentation that had been presented, the fact that the practical difficulty (mistake) was not created by the applicant, the approval will resolve the issue in both a cost effective and timely manner and this is a very unique situation that will not create precedence. Chairman/Otter Tail County Board of^justment Permit(s) required from Land & Resource Management Yes (Contact Land & Resource Management) :diLQ) kJUjjocZ)X_ No Copy of Application Mailed to Applicant, Co. Assessor and the MN DNR L R Official/Date bk 072011-001 i. October 6, 2011 Page # 3 Duane and Denise Mischel - Continued. (7:30 p.m.) The motion as offered did not directly or indirectly grant any other variances for Lot 1 Block 2. It was noted that this motion was offered to provide an opportunity for the property owner to enjoy the same rights and privileges as others in this immediate area. The motion denied for lack of a second. After additional consideration and discussion, Steve Schierer made a motion, seconded by Thomas Lee and unanimously carried, to deny the variance as requested^as no adequate practical difficulty unique to the applicants’ property had been shown that would allow for the granting of the variance as requested and the granting of the variance as requested would create a grossly substandard lot. This is a new plat and a condition of the plat is that Lot 1 Block 2 is to be considered a nonbuildable lot. Pamela Hovland -Application approved as requested. (7:42 p.m.) Pamela Hovland, Lot 10 South Lida Shores, Lake Lida in Maplewood Township, requested a variance of 15’ from the required ordinary high water level setback of 75’ for the construction of a dwelling 60’ from the ordinary high water level. Cory Reinertson, Contractor, represented the applicant at the public hearing. The audience was polled with no one speaking for or against the variance as'requested. After consideration and discussion, Paul Larson made a motion, seconded by Steve Schierer and unanimously carried to approve a variance of 15’ from the'required ordinary high water level setback of 75’ for the construction of a dwelling 60’ from the ordinary high water level. The practical difficulty is the terrain of the applicant’s property. The applicant proposal is moving further back and is an improvement over the existing development. Charles and Barb Ludvigson - Denied the application as submitted. (7:47 p.m.) Charles and Barb Ludvigson, part of Government Lot 2, Section 30 of Otto Township by Rush Lake, requested the following: We propose to leave the boat house foundation at its current height which is approximately 12” less than the standard height. The site has been inspected and all other site requirements have been met. An additional 12” would be prohibitive and impractical for the entrance into the structure as intended for water craft storage. By adding 12” to make it accessible would require hauling fill and putting land surrounding the building on grade. This would result in diverting water after heavy rain into the adjourning property, who already deals with ponding issues. Current height is 2’. Required height is 3’. Seeking variance for 1’for elevation above ordinary high water level. The audience was polled with no one speaking for or against the variance as requested. An email from Kathy Murphy and Dean Laager in support of the variance as requested was read for the record. After consideration and discussion, Randall Mann made a motion, seconded by Steve Schierer and carried with Leona Zimmerman voting no, to deny the variance as requested as no adequate practical difficulty unique to the applicants’ property had been shown that would allow for the granting of the variance as requested. The general opinion was that the practical difficulty vyas self-imposed and the additional T of elevation would not be unsightly. Jacobson Family Revocable Living Trust - Application approved as requested. (7:58 p.m.) Jacobson Family Revocable Living Trust, Lots 16, 17 and 18 Fair Oaks, West Battle Lake in Girard Township, requested the following: I request a variance from the conveyance of a platted and now substandard lot which was mistakenly conveyed from the ownership of Dean Jacobson, Jr., to the Jacobson Family Revocable Living Trust. The Trust has since conveyed the property to Paul and Kristina Kostelecky, but because adjoining Lots 16 and 17 of Fair Oaks are also owned by the Trust, the deed of conveyance was not allowed to be recorded. I would request that Lots 16 and^7 be a residential buildable lot and that Lot 18 be a separate residential'buildable lot. There are no other owners in the plat of Fair Oaks whose total ownership exceeds 150 feet by approximately 150 feet, which would be the remaining size of Lots 16 and 17, the size of the remaining parcel owned by the Trust if the variance for the sale of Lot 18 is granted. We simply ask for the same rights and privileges as other owners of the plat. We might also point out that Dean Jacobson had Alzheimer’s and Iris Jacobson was a vulnerable adult when she signed the deed., If the variance is not granted, we will have to go through a court procedure to have the deed vacated, which we are confident will be accomplished, but granting the variance will save the owners substantial time and expense. I would request that Lots 16 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. Kristian Svingen, Attorney and Diana L. Johnson, applicant’s daughter represented the applicant.at the public hearing. The audience was polled with Marvin Rapp and John Halting speaking for the variance as requested. Letters and/or emails from Thomas Weiss, Lynda Merry, Elizabeth Harrison, Stan Nelson, Maryln Rapp, Tim Matz, Jo Matz, Michael Anderson and Karen Anderson in support of the variance as requested were read for the record. • October 6, 2011 Page-#4 Jacobson Family Revocable Living Trust - Continued. (7:58 p.m.) After consideration and discussion, Thomas Lee made a motion, seconded by Steve Schierer and carried with Paul Larson voting no and with Randall Mann abstaining, to declare combined Lots 16 and 17 Fair Oaks as one residential buildable lot and to declare Lot 18 Fair Oaks as a separate residential buildable lot. Those abstaining and'voting against the motion to approve noted that the granting the variance is correcting an attorney’s mistake and is a self- imposed practical difficulty. Those supporting the motion to approve noted the documentation that had been presented, the fact that the practical difficulty (mistake) vyas not created by the applicant, the approval will resolve the issue in both a cost effective and timely manner and this is a very unique situation that will not create precedence. Peter and Stephanie Christianson -Application approved as requested (8:16 p.m.) Peter and Stephanie Christianson, Lot 34 Stony Point, West Battle Lake in Everts Township, requested the following: Project requires 340 square feet of additional impervious surface. The proposed project will change the impervious surface percentage from 35.5% to 38%. The maximum allowable impervious surface coverage is 25%. The audience was polled with no one speaking for or against the variance as requested. After consideration,and discussion, Paul Larson made a motion, seconded by Thomas Lee and carried with Steve Schierer voting no, to approve the variance for the proposed development as described in the application dated September 13, 2011 and as depicted on the drawing submitted vyith application.. It was noted that much of the existing impervious surface was placed on this property to prevent erosion and to direct the water from flowing directly into the lake. Richard Brink - Application approved as requested. (8:25 p.m.) Richard Brink, Lots D and E of Schwingler’s Subdivision of Lot 16, Oak Grove Beach, Rush Lake in Rush Lake Township, requested a variance of 20’ from the required ordinary high water level setback of 75’ for the placement of a porch (screen) 55’ from the ordinary hjgh water level. The audience was not polled as there was no one in attendance other than the applicant and the applicant’s wife at the time of this public hearing. A letter from Greg and Brenda Potter in support of the variance as requested was read for the record. After consideration and discussion, Steve Schierer made a motion, seconded by Thomas Lee and unanimously carried, to approve a variance of 20’ from the required ordinary high water level setback of 75’ for the placement of a porch (screen) 55’ from the ordinary high ■ water level. The applicant replaced an existing deck with a porch, which will be no closer to the ordinary high water level than the existing deck. Thomas and Jayne Piehl - No Action Thomas and Jayne Piehl, Lot 2 Block 1 Big Pine Haven, Big Pine'Lake in Pine Lake Township, requested the ’ following: need more room for drain field either setback from - Option 1 - Lot Line'5 feet. Option 2 ^ Dwelling 17 feet or Option 3 - Bluff 5 feet July 7, 2011 meeting - The audience was polled with no one speaking for or against the variance as requested. After consideration and discussion, Steve Schierer made a motion, seconded by Thomas Lee and unanimously carried, to table with the verbal agreement of the applicant this public hearing until the September 1,2011 meeting of the Board of Adjustment, which will provide the applicants with adequate time to obtain the distance between the proposed drain field and the neighbor’s dwelling and with an opportunity to obtain a letter of support from the neighbor. August 4, 2011 meeting - No action taken as the applicants had requested at the July 7, 2011 meeting to have their hearing tabled until the September 1, 2011 meeting. September 1, 2011 meeting - No action taken as the appl|cants:had submitted an email on Tuesday, August 16‘^, 2011 requesting the tabling of their request until the October 6*^ meeting of the Board of Adjustment due to health issues. October 6, 2011 Meeting - Prior to the October 6, 2011 meeting, the office was contacted by Thomas and Jayne Piehl informing the office of their intent to withdraw their application. With no further business, Randall Mann, Chairman declared the meeting adjourned at 8:35 p.m. Prepared _by: SiWayne flfein. Secretary The minutes were mailed on Friday, October 7\ 2011 to the Otter Tail County Board of Adjustment. Official action regarding these minutes will be taken by the Board of Adjustment at their next regularly schedule meeting. yW. I, I I I 2^000^1O(p6.5OO0 jn-^^OOO^^O^io^OQO j z^ooo f fo-(> (ff3oQO!i- Tax Parcel Number(s) The scale drawing must be a signed drawing which inciudes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface caiculations.;>'-r^ /n.qg'2. %, . -■ Impervious Surface Ratio (Must Complete Worksheet On Other Side) Scale /T / -I T \ H »-jllll. ......- -........Ca-ar *. n ■ 1 r ^ll I,^7IIS;i9•i a1 -’t,-in)L I "U.£DV 5 ha'C:X •S31 -3 I0 i=5^___aJT (-5 A i:ft 0""•i-' i.1B S£ 4.V.-i li vie; u U'P/f-y-d/tjr V, 5■■■ '*? t fi [_I r'j jj. i \ s?s !!Z ;s \ I ,,f.i • /. • \iW¥7" i\]/■\...;i j. . V w i1 4- j I >-;!ai .^u31- tt^1 A \ 3kf .....'! j' :i)S % n Jk..L¥5f ■ ffi 1<fr- O < •:^gci \ ■*- m. Q ■4. ■t:i )U ^ '•••■ s=±r|j VjJ) J- ' Signature of Proper y Owner -..-...—I I I i—1_i_i—i—I------- -i--/VY-' t : -I H X" .MN-7-1-800-346-4870BK = 0909 .338,59 5_y...Victo tdi Ca,.Pnniws-» . Fergus I oilen&Ii TIMPERVIOUS SURFACE CALCULATION WORKSHEET: List of Onsite (Existing and Proposed) Impervious Surfaces (must be shown on scale drawing): P2 10 MU\r(tz^L HK-CH 1^0 VJO^O PI^L SH Ft2-/r^0A/r 3or tfo'^ IS oy/e/z. Lor/t.^ poJKh sr/sfucrv/^e^ Structure(s); -SHODeck(s): I %00 R2 -^ 0- "/ p^2 Driveway(s):i POC- /?2. phrio s^wg^Patio(s): / S'^oSidewalk(s):Ff2 ^ Ft2 TO p£<X l5^Ft2 Stairway(s): Retaining Wall(s); Landscaping: (Plastic Barrier) Other; Ft2 Ft2 TOTAL IMPERVIOUS SURFACE:Ft2 Itf, /qgroo - ‘ 3t)^ i-?1.^3^^ <^0 0 Ft2 k tLOT AREA:II 6 04’ (g ./f i/ii-fT/X100 =% TOTAL IMPERVIOUS SURFACE LOT AREA IMPERVIOUS SURFACE RATIO L07~ I i z. .2(0 07 STOgACri. 6^!^ fd^g'oOFi'^ - Lot^ I ^ 10 oTT) /oy. (.P- J JS' X /oo SI ^5", 7Z) I I ■' ! ■/. t^ I I P(?CS1,f3^ Sri^^ycTui?. & s z<?yiL - /M 2_?'/i32.- WJOP 4^yi_£. I-??*! po^^H 7^1) y'j’D'pdi— piArfoR^ (8£/'a^6- ^rrxOijq,^) _ poit-cH _S:^7r___f/VTiO ^;0£Vv/AU<^-^■ .T11=^0 .J-\(4Qs.r ^ 'P ^ )+ui;sc,i3Ac.l<! l"7 pro B£ so ^ r'\n‘)L fC-S -r=> fpTM D£i/y\oust*^C> f September 21,2011 Otter Tail County Government Service Center SlOFirAveW Fergus Falls Mn 56537 Mike and Karen Anderson 7701 KingsvieAV Lane North Maple Grove Mn 55311 RE: Lots 16,17 and 18 Fair Oaks Jacobson Family Revocable Living Trust To Whom It May Concern: We agree to let lots 16 and 17 be residential buildable lots and that Lot 18 be a separate residential buildable lot. Sincerely Michael A Anderson & Karen Anderson Phone 763-494-3775 > Notice of Hearing for Variance Otter Taii County Government Services Center 510FirAveW Fergus Fails, MN 56537 (218) 998-8030/998-8041 Email - wstein@co.ottertail.mn.us www.co.otter-tail.mn.us Applicant and/or applicant's representative must be present at the scheduled hearing. To Whom It May Concern: Jacobson Family Revocable Living Trust PO Box 9 Clitherall, MN 56524-0009 has made application to the Otter Tail County Board of Adjustment for a variance as per requirements of the Otter Tail County Shoreland Management Ordinance, the Otter Tail County Set Back Ordinance and/or the Subdivision Controls Ordinance. The Otter Tail County Board of Adjustment will assemble for this hearing on Thursday, October 6, 2011 at 7:30 p.m., in the Commissioners' Room of the Otter Taii County Government Services Center, Fergus Falls, MN. (Please use the public entrance located on the northeasterly side of the Government Services Center. The second left o^f Fir Ave.) Individuals requiring special accommodations should contact the County Auditor's office prior to the date of the public hearing. The property concerned in the application is legally described as Lots 16,17 and 18 Fair Oaks, Property Address-41531 Ukkelberg Drive Section 29/32, Township 133, Range 39 - Township Name - Girard Lake No. 56-239, Lake Name - West Battle, Class - GD The variance requested is - the following: I request a variance from the conveyance of a platted and nov/ substandard lot which was mistakenly conveyed from the ownership of Dean Jacobson, Jr., to the Jacobson Family Revocable Living Trust. The Trust has since conveyed the property to Paul and Kristina Kostelecky, but because adjoining Lots 16 and 17 of Fair Oaks are also owned by the Trust, the deed of conveyance was not allowed to be recorded. I would request that Lots 16 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. There are no other owners in the plat of Fair Oaks whose total ownership exceeds 150 feet by approximately 150 feet, which would be the remaining size of Lots 16 and 17, the size of the remaining parcel owned by the Trust if the variance for the sale of Lot 18 is granted. We simply ask for the same rights and privileges as other owners of the plat. We might also point out that Dean Jacobson had Alzheimer’s and Iris Jacobson was a vulnerable adult when she signed the deed. If the variance is not granted, we will have to go through a court procedure to have the deed vacated, which we are confident will be accomplished, but granting the variance will save the owners substantial time and expense. I would request that Lots 16 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. Wc^ieSUin Board of Adjustment Secretary Date: September 15, 2011 jdtu V f •9^ . ( Y ~^/v< /J /lAyt^ -^Jj^ ^ C^’^lA^y iyj x.'^^^^ i;^jY7y'^Ji‘'{ xJhe-CA y\jy C^C 7 / 1^ J~i %\ A,'i, <y<' % Q? c> Wayne Stein ,OTC Auditor 510 Fir Ave West Fergus Falls,MN 56537 RECBiVeo OCTO5 20U Ol/c. , FERGUS FALLS.m This letter is in regards to the Jacobson Family Revocable Living Trust variance. I feel that this variance should be approved by the board. We have owned property next to the Jacobson’s since 1989. We have a 75’ lot just as most of the other property owners in the area. The size of the lot has never been a problem for us. Besides that Deans cabin is already on 2 lots. I don’t think he should be penalized by not allowing him to sell this lot, just because it’s next to his other property. Stan Nelson 725 S. Tower Rd Fergus Falls.MN 56537 MARVIN L. RAPP 41555 ukkelberg Dr, Clitherall, MN 56524 218-262-0181 September 27,2011 f^ECEIVSO OCTOC20U Wayne Stein Ottertail County Auditor 510 Fir Avenue West Fergus Falls, MN 56537 RE: Dean Jacobson Property Having read the request for Variance regarding the Jacobson Trust I can see no reason for the variance not to be approved. I live immediately to the east of the parcel in question. It only seems reasonable to me that a home could be built on this parcel. All of the homes in this area are on 75 foot lots. ^Wayne Stein Tim &Jo Matz <tjmatz@hotmail.com> Tuesday, September 27, 2011 10:31 PM Wayne Stein Jacobson Family Revocable Living Trust From: Sent: To: Subject: Dear Mr. Stein We are owners of lot 20 Fair Oaks and are familiar^with the Jacobson request for variance. We have no objection to allowing lot 18 becoming a separate buildable lot. I-'" Tim 8i Jo Matz 517 18th Ave N Wahpeton, ND 58075 i K < . 1 Thomas Weiss & Lynda Merry' 11297 Baltimoi'e Street NE, Unit B Blaine, MN 5i)4'19 received September 2fi. 2011 SEP26Z011 01 TER IAIL^u.mUOITOR FERGUS FALLS MN Wayne Stein Otter Tail County Auditor 510 Fir Avenue W^est Fei^s Falls, MA ,50537 Dear Mr, Stein, We have received and iv“ad the a|)plication for a variance for the Jacobson Family Rcvocahle Living Trust and give our support for the approval of the wcpiested variance. If you should have any questions prior to the October 6,2011 meeting, you can contact Thomas at 612-581 -5935, or Lynda at 612-270-1844. Sincei'ely yours. Thomas Weiss Lynda Meny Application for Variance - Exhibit A I request a variance from the conveyance of a platted and now substandard lot which was mistakenly conveyed from the ownership of Dean Jacobson, Jr., to the Jacobson Family Revocable Living Trust. The Trust has since conveyed the property to Paul and Kristina Kostelecky, but because adjoining Lots 16 and 17 of Fair Oaks are also owned by the Trust, the deed of conveyance was not allowed to be recorded. I would request that Lots 16 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. There are no other owners in the plat of Fair Oaks whose total ownership exceeds 150 feet by approximately 150 feet, which would be the remaining size of Lots 16 and 17, the size of the remaining parcel owned by the Trust if the variance for the sale of Lot 18 is granted. We simply ask for the same rights and privileges as the other owners of the plat. We might also point out that Dean Jacobson had Alzheimer’s and Iris Jacobson was a vulnerable adult when she signed the deed. If the variance is not granted, we will have to go through a court procedure to have the deed vacated, which vye are confident will be accomplished, but grantingJhe variance will save the owners substantial time and expense. Scale Drawings - see attached. 868452 Booth Ogcumocta 4 Publ, Co.Fotm No. 2027 - Quit Ctalm Poetf^ Minnesota Uniform Conveyanddfl Blanks (MB-97)ImNvtduaife) to lndivldu8t|s) No delinquent taxes and transfer entered; Certificate of Real Estate Value ( ) filed ( ) not required Certificate of Re«il Estate Value No. Date: OFFICE OF COUNTY RECORDER OTTERTAIL MINNESOTA 868458 was filed/recorded In this office forxscofd oiuhe lla day of __llUfniST. _2000atailO_an^ Met^lf, bounty Recorder ^ /U.-MDO County Auditor aWent Deputy by;.Deputyc^^-ooo-99-oc,iff^'aon .recording fee .well certHicaleDEED TAX DUE: $ I . 4 5T l/i». 7)OOC)Date:(reserved for recording data) !<1 ^Ser!/, ^Ti-. ^ -Jci-e:ahSon e, ,'p vj7 ^ < g (■<=( Aarnn'^^rantorfs), ^Tj3Ljc:.£> k? FOR VALUABLE CONSIDERATION, J K ^ S \7<z^ e^[ ^ hereby convey(s) and quitclaim(s) to__r j Granteefs), real property in C?‘T<S\r ~T~a^ i I L ^T' IS o'f' FAil^ OAKS, To T“he oTT/ee o-^ T~he C 3/ , ^ ^ yU^£Se>Tlll^ County, Minnesota, described as follows: p («_T ~TTi e*^e <t>f C,a\rc.{<2.c\ i t-i OTTev^ O C* F1 c;c. ; ( a > Jjfjs-oo, esI <? Ti_ I C. oi^ 5" t iri 6 t^otTi o IT Ie-rx 7“/i«- together with all hereditaments and appurtenances. Check box if applicable: |S| The Seller certifies that the seller does not know of any wells on the described real property. O A well disclosure certificate accompanies this document. O I am familiar with the property described in this instrument and I certify that the status and number of wells on the described real property have not changed since the last previously STATE OF MINNESOTA COUNTY OF Pljertii! ! This instrument was acknowledged before me on/hjA U'vt ^ by TVdLvi . ,^T? Tci s A Jar tihiovi I ss. <1 :C: e.lai , Grantor(s). ------- FMOTARY PUBLIC OR OTHER OFFICIAL NORTARlAf. STAMP OR SgALfQRQmpf TlTlJOP PAMinLORI LEE THOBSEN \ NotaryPublQf Mmetoti«(|OMBR<»lon&0tatenaBB * 5/^ Check here if part or ail of the land is Registered (Torrens) Q Tax Statements for the real property described in this. ‘ ' ^ instrument should be sent to (include name and address of Grantee): THIS INSTRUMENT WAS DRAFTED BY (NAME and ADDRESS)!; y\ c» J'^ ;■ <S<Z- h fo 6ok ^ (2, 1 I *Ph ^ ^C- Itthe-r^U, ^ H S6SAH r * 1080596OFFICE OF COUNTY RECORDER OTTER TAIL MINNESOTA I hereby certify that . nianc:Q.c this instrument # -mouojo wasflled/recorded in this office for record on the /j day of fc'iiSsL. «6mlliitlM / No delinquent taxes and transfer entered; Certificate of Real Estate Value ( Certificate of Re£d Estate Value No____ /3 ) filed { ) not required. ■ ^0/0 (Year) anmmWayne Stein, County Auditor koeputy'’Cxby Deputy well certifica COUNTY OF OTTER TAIL STATE OF MINNESOTA DEED TAX S JtJOS.__ DATE Q^^=J3^{^ QUIT CLAIM DEED Individuals to Trust STATE DEED TAX DUE HEREIN: $1 65 Dated; 2010 FOR valuable consideration. Dean Jacobson, also know as Dean Jacobson, Jr., and Iris Jacobson, also known as Iris A. Jacobson, husband and wife, Grantors, hereby convey and quitclaim to Dean Jacobson, Jr. and Iris A. Jacobson, Trustees, or their successors in (rust, under the Jacobson Family Revocable Living Trust, dated September 20, 2007, Grantees, real properly in Otter Tail County, Minnesota, described as follows: r- \ / / Lot Eighteen (IS). Fair Oaks TOTAL consideration FOR THIS TRANSACTION IS S500.00 OR LESS TO HAVE AND TO HOLD THE SAME, together with all the hereditaments and appurtenances belonging thereto. STATE OF MINNESOTAk ) ) ss. COUNTY OF OTTER TAIL ) SgpVg«^^cs‘'. The foregoing instrument was acknow'ledged. before me this 2010, by Dean Jacobson, Jr. and Iris A. Jacobson, husband and wife, grantors. day of TRICIA A. OHLROGGE | *)NOTARY PUBLIC-MINNESOTA | My Comm, Exp. Jan. 31,2014 J Notary Public This instrument was dnirtcti by-.Ta,\ statements for the pmpcriy described in this instrument .should be .sent lo; Dean Jacobson. Jr. & Iris A. JacobsonHATLING LAW OFFICE 1005 Pebble Lake Road Fergus Falls, Minnesota 56537 218-736-2076 P.O. Bo.x 9 Clitherall, MN 56524-0009 Dean Jr. <5 Iris Jocohson-'Otter Toil County :I S i ; I I i z “I SHEET 2 OF 2PLAT OF lake niK'-v. l•n»»;^•T.•• ‘iini SECTION 52. TWP 153 NORTH, RANGE 39 WEST. AND SECTIO TWP. 135 NORTH. RANGE 59 WEST, FIFTH PRINCIPAL MERIDIA battleFAIR OAKS ^EST N 29_-------------\.................... ......... "| ( M.-- |-lpr' lr< f-V.in, ^ FAIR OAKS1 PART Of The southeast-quarter OF THE NOR T HWES1 - QUARTER OF SECTION 32.TWP. i53 NORTH. RANGE 39 WEST, 9EGINNING AT IME northwest corner of said S.E.J^ OF N.W,!/4 thence S.OO*23' W. 101.1 FEET ALONG THE WEST LINE THEREOF, ThEnCC 319.0 FEET TO The NORTH LINE THEREOF; 30L3 FEET N.7 I- 12' E.. THENCE S-a9*42’W. TO THE POINT OF aEGiNNiNG, CONTAINING 07 ACRE ALL OF GOVERNMENT LOT 2. ALL OP GOVERNMENT LOT 3 ANO ALL OF GOVERMENT LOT * IN SECTION 32. TWP 133 NORTH, RANGE 39 WEST, CONTAINING 113,35 ACRES MORE OR LESS, ACCORDING TO THE GOVERNMENT PLAT THEREOF. ALL OF GOVERNMENT LOT I, IN SECTION 29, TWP |33 NORTH. RANGE 39 WEST CONTAINING 9.05 ACRES MORE OR LESS. ACCORDING TO THE GOVERNMENT PLAT THEREOF. I iiWNKII> t'KHTlKll'.\TK 5, ..............iiTi.l |>Twprh'l«ir> .<1 Ih.. fcillnv.111,' ir^ci. Ml j.„ri**l« nf IatiiI au.1 l-'inic m 1'>- roiinlj nf Oiti.r TmiL SIaIi. Ilf Uirini.Bi.Tii mi.l iL-wriUvl fi.||n«j rnKiff: I'KHSuN-*^ B> niK rKh fSiTl,KN-i'V .\I.I.FJ- III. "I ,1 , .r4-0O«' l'^6 UL3?IV -| H.V1 (Ml I' l^^.l.•^:l>r II.OO I' :(/>Jtd^ ^is^-\§'ffl llJ i > O uj a: PART OF TmE SOUTHEAST-QUARTER OF THE NORTHWEST-QUARTER \o HCE 39 WEST. BEGINNING AT THE . OF N.W '/a thence S.00*23’W., OF SECTION 32.TWP 133 NORTH. RAI NORTHWEST CORNER OF SAIO S.E.^ lOl.l FEET ALONG THE WEST LINE THEREOF; THENCC N.7I*I2‘ C.. .yt/V5-<a.T:,/ '5 u 319.0 FEET TO THE NORTH LINE THEREOF; THENCE. S. 89 42 W. 3013 FEET TO THE POINT OF BEGINNING; CONTAINING 0.7 ACRE.• UJ-y-CO , I'.^G U.fiir, ...<i1(VI uiI i. ■ UJ ALL OF GOVERNMENT lOT 2, ALL OF GOVERNMENT LOT 3 AND ALL OF GOVERNMENT LOT 4 IN SECTION 32 TWP. 133 NORTH. RANGE 39 WEST. CONTAINING 113.35 ACRES MORE OR LESS ACCORDING TO THE GOVERNMENT PLAT THEREOF. u.o: Critf.rT;l IN SECTION 29. TWP 133 NORTH, 9.05 ACRES MORE OR LESS ALL OF GOVERNMENT LOT RANGE 39 WEST; CONTAINING ACCORDING TO THE GOVERNMENT PLAT THEREOF. 1 /X;s2ri2,..in ST • \\ liirh |uirl .1* «^nl^ li-r- in tin' nii.l.‘rMi*iiiO ha.i. |.bum-<1 In >-■ -iinr>i.i] 4jul uni. iliTi.leil mfn pr-Unrr,J SBiJ ftflcr Ihf. <imMijiHi uml ri-'i.r.lin^ ihn ■■pi «S..M*ril«p1 pri.|ipriT >iuill hi.n. Ill th.. ifulili** DPP forri.T all rna.lPBVp bp U^ptnl B.P bIivdii hD :1ii' i\nrii*\—I |.lni. :5 i;T' ► LI K<», Kermit T. 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LDM.MlSSliiNKIlH \ih\i.\;/<i/tiik ih'\hii ui.\vi:m»i'.\ fKRfAII?C^NTV 3 .1 Notice of Hearing for Variance Otter Taii County Government Services Center 510FirAveW Fergus Faiis, MN 56537 (218) 998-8030/998-8041 Email - wstein@co.ottertail.mn.us www.co.otter-tail.mn.us v>;' Applicant and/or applicant’s representative must be present at the scheduled hearing. To Whom It May Concern: Jacobson Family Revocable Living Trust PO Box 9 Clitherall, MN 56524-0009 has made application to the Otter Tail County Board oFAdjustment for a variance as per requirements of the Otter Jail County Shoreland Management Ordinance, the Otter Tail County Set Back Ordinance and/or the Subdivision Controls Ordinance. The Otter Tail County Board of Adjustment will assemble for this hearing on Thursday, October 6, 2011 at 7:30 p.m., in the Commissioners’ Room of the Otter Tail County Government Services Center, Fergus Falls, MN: (Please use the public entrance located on the northeasterly side of the Government Services Center. The second left off Fir Ave.) Individuals requiring special accommodations should contact the County Auditor’s office prior to the date of the public hearing. The property concerned in the application is legally described as -Lots 16,17 and 18 Fair Oaks, Property Address - 41531 Ukkelberg Drive Section 29/32, Township 133, Range 39 - Tovynship Name - Girard Lake No. 56-239, Lake Name - West Battle, Class - GD The variance requested is - the following: I request a variance from the conveyance of a platted and now substandard lot which was mistakenly conveyed from the ownership of Dean Jacobson, Jr., to the Jacobson Family Revocable Living Trust. The Trust has since conveyed the property to Paul and Kristina Kostelecky, but because adjoining Lots 16 and 17 of Fair Oaks are also owned by the Trust, the deed; of conveyance was not allowed to be recorded. I would request that Lots 16 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. There are no other owners in the plat of Fair Oaks whose total ovynership exceeds 150 feet by approximately .150 feet, which would be the remaining size of Lots 16 and 17, the size of the remaining parcel owned by the Trust if the variance for the sale of Lot 18 is granted. We simply ask for the same rights and privileges as other owners of the plat. We might also point out that Dean Jacobson had Alzheimer’s and Iris Jacobson was a vulnerable adult when she-sighed the deed. If the variance is not granted, we will have to go through a court procedure to have the deed yacated; which we are confident will be accomplished, but granting the variance will save the owners substantial time and .expense. I would request that Lots 1'6 and 17 be a residential buildable lot and that Lot 18 be a separate residential buildable lot. Wayne Stein Board of Adjustment Secretary 1' Date: September 15, 2011 OTTER TAIL COUNTY Fergus Falls, Minnesota State of Minnesota ) )SS County of Otter Tail) I, Wayne Stein, Secretary for the Board of Adjustment for Otter Tail County, Minnesota, do hereby certify that on the 19th, day of September, 2011 the attached Notice of Hearing for Variance was duly served upon the individuals listed below and/or included in the attachment: Jacobson Family Revocable Living Trust, PO Box 9, Clitherall, MN 56524-0009 Carol Jacobson, Twp Clerk of Girard; 24893 Palace Road, Battle Lake, MN 56515 West Battle Lake Assoc., Blaine Larson, 38323 Front St, Battle Lake, MN 56515 Otter Tail County Cola, % John Matteson, 23674 W Silver Lake Rd, Battle Lake,MN 56515 Richard West, OTC HWY Engineer, 505 S. Court St. Suite #1 Fergus Falls, MN 56537 Terry Lejcher, 1509 1^‘Ave N., Fergus Falls, MN 56537 DNR Regional Administrator, 2115 Birchmont Beach Rd. NE, Bemidji, MN 56601 Board of Adjustment: Paul R. Larson, 21283 County Highway 65, Henning, MN 56551-9573 Richard S. Schierer, 32117 260th Ave, Erhard,MN 56534 Thomas (Tom) Lee, 15600 Cty Hwy 118, Elizabeth, MN 56533-9559 Randall Mann, 532 N. Ann St., Fergus Falls, MN 56537 Michael Harris, 35387 Northern Lights TrI, Richville, MN 56576-9672 Leona Zimmerman, 418 E Lakeside Dr, Fergus Falls, MN 56537 by placing a true and correct copy thereof in a sealed envelope, postage prepaid, and depositing the same in the United States Mail at Fergus Falls, MN, property addressed to each of the individuals listed above and/or listed in the attachment. Dated: September 19, 2011 Wayne Stein, Secretary Otter Tail County Board of Adjustment By: Vi Manderud HARLEY & DIANNE ANDERSON 7946 180TH AVE SE WAHPETONND 58075 9418 CJ LAKESIDE LLP 508 3RD ST N SARTELL MN 56377 1745 MICHAEL A & KAREN N ANDERSON 7701 KINGSVIEWLN N MAPLE GROVE MN 55311 2134 BRADLEY & LORI L HARTKOPF 9768 TROY LN N . MAPLEGROVEMN 55311 1615 KEVIN & JULIE DOTZENROD ,9256 IVES LNN MAPLEGROVEMN 55369 3919 ELIZABETH HARRISON 1226 19TH AVENE ROCHESTER MN 55906 4306 MARK J & SUSAN M KOPLIN 8728 SANDRO RD MINNEAPOLIS.MN 55438 1229 DEAN JR & IRIS A JACOBSON LORI & CURTIS JOHNSON 7844 COUNTY ROAD 39 NE MONTICELLOMN 55362 2922POBOX9 CLITHERALLMN 56524 0009 LYNDA MERRY & THOMAS WEISS 11297 BALTIMORE ST NE UNIT B BLAINE MN 55419 4678 JAMES I & ANNE L MELVILLE 1137 RIVER ST W MONTICELLO MN 55362 8952 , TIM E & MARY JO MATZ 517 18THAVEN WAHPETON ND 58075 3321 PAUL H ORNDORFF 93010THAVEN SARTELL MN 56377 2258 , ROGER A & ELIZABETH MYKLESTAD 308 COUNTY HIGHWAY 1 t OTTERTAILMN 56571 7022 STANLEY A & DEBRA J NELSON 725 TOWER RDS FERGUS FALLS MN 56537 1076 PAUL H & JANE E ORNDORFF 930 10THAVEN SARTELLMN 56377 2258 - DOUGLAS W & DOREEN J STAVE 514 23RDAVEN FARGO ND 58102 1927 MARVIN RAPP 12615 LOST MAPLES SAN ANTONIO TX 78253 5738 DELORISWYNN 1625 6TH STN WAHPETON ND 58075 3303 i SVINGEN. CLINE LARSON. P.A. ATTORNEYS 6 COUNSELORS AT LAW Attorneys: R. Kristian Svingen J. J. Cline Greg Larson Thomas C. Athens Telephone: 218-998-4088 Facsimile: 218-998-4087 Toll Free: 888-498-5599 October 6, 2011 Otter Tail County Auditor Government Services Center Slowest Fir Fergus Falls, MN 56537 Jacobson Application for Variance Lots 16, 17 and 18, Fair Oaks Scheduled for Hearing on October 6, 2011 RE: Enclosed is the original and 10 copies of the Scale Drawing Form which was requested. Very truly yours. R. Kristian Svingen km Enc. 125 South Mill Street, Fergus Falls, MN 56537 www.svingenlaw.com Offices in Fergus Falls, Pelican Rapids and Battle Lake Weekly Office Hours in Vergas, Dalton and Underwood SVINGEN, CLINE LARSON. P.A. ATTORNEYS 6 COUNSELORS AT LAW Attorneys: R. Kristian Svingen J.J. Cline Greg Larson Thomas C. Athens Telephone: 218-998-4088 Facsimile: 218-998-4087 Toll Free: 888-498-5599 October 5, 2011 Otter Tail County Auditor Government Services Center 510 West Fir Fergus Falls, MN 56537 Jacobson Application for Variance Lots 16, 17 and 18, Fair Oaks Scheduled for Hearing on October 6, 2011 RE; Enclosed are materials as part of our presentation at the hearing tomorrow if you wish to distribute them before the hearing: Affidavit of John A. Hatling. Affidavit of Tricia A. Shaw. Affidavit of Diana Jonson. Letter from Daniel Lembcke, M.D. 1. 2. 3. 4. Very truly yours. R. Kristian Svingen 1^1 Enc. 125 South Mill Street, Fergus Falls, MN 56537 www.svingenlaw.com Offices in Fergus Falls, Pelican Rapids and Battle Lake Weekly Office Hours in Vergas, Dalton and Underwood . Affidavit of John A. Hatting 1. I am John A. Hading, an attorney at law licensed to practice in the state of Minnesota. 2. I have in the past represented Dean and Iris Jacobson. I-specifically represented the Jacobsons for the purpose of preparing an estate plan; which included a revocable living trust, in 2007. When the preparation of the trust document had'been completed, the Jacobsons identified certain tracts of real property they owned (Lots 16, & 17, and 18, Fair Oaks), and asked for advice aboufthe titling of sarne. We discussed the need to convey their homestead (Lots 16 and 17) to their trust. My office accordingly prepared a Quit Claim Deed that conveyed the homestead to the revocable living trust. I discussed with the Jacobsons the titling of an adjacent tract they owned (Lot 18); they specifically stated that Lot 18 should not be titled to the trust because of concerns about the Otter Tail County Shoreland Management ordinance. They stated that if their three tracts would all be titled to the trust that they would then be unable to sell Lot 18 separately. It was important to them to be able to sell Lot 18 alone if needed in the future. My office prepared a deed to convey Lots 16 and 17 to the trust; no deed was prepared that conveyed Lot 18 to the trust. It was intentionally not conveyed because of the stated concern about the titling of the tracts. 3. ■ In July 2010, my paralegal, wHo was not erhployed by my office at the time I first met with the Jacobsons, learned that the Jacobsons still owned a tract of adjacent land that had not been conveyed to the Jacobson’s trust; She was rightfully concerned about the tract of land that was not to be titled to the trust. She called the Jacobsons to discuss this concern. Ultimately, the Jacobsons signed the deed that conveyed Lot 18 to the trust; my paralegal also caused the deed to be filed with the Office of the Otter Tail County Recorder. 4. I did not give the recorded deed another thought until I received a call from Diana Johnson, daughter of the Jacobsons. She stated that her parents had sold Lot 18, but that the Purchasers were unable to record the deed. Apparently, the county auditor would not approve the deed for recording because it was contiguous to the other tracts similarly titled. 5. I am convinced that the deed conveying Lot 18 to the Jacobsons’ revocable living trust was recorded erroneously. The Jacobsons had at one time advised my office that Lot 18 should not be conveyed to the trust, because to do so would restrict the sale of that tract.. The deed would still not be recorded were it not for a’diligent and well intentioned (but mistaken) paralegal, who was simply taking steps to ensure that our clients’ affair were all in order. As it is, a good faith purchaser has been left unable to record the deed that memorializes their purchase. The Jacobsons and the Purchasers are both left in a very difficult position if the petition for variance is not granted. 6. The Board of Adjustments should recognize that a mistake has been made and permit the petition for variance. Lot 18 should not have been conveyed to the Jacobson trust; but for the mistaken conveyance, the good faith purchasers could have recorded their deed without any hesitation. ■' .r> FURTHER YOUR AFFIANT SAITH NAUGHT. m-G ,2011Date:If/ohn A Hatling Subscribed and sworn to before me, day of ,2011. 1^4% triciaa: OHLROGGE I f^OTARY PUBLIC Wy Com.n. Ex?, Jan. 31,2014 | I■MINNESOTA € Affidavit of Tricia A. Shaw 1. lam Tricia A. Shaw; I am a paralegal employed by the office of attorney John A. Hatling. 2. I am employed by a general practiee law firm; the firm prepares a number of estate planning portfolios and living trusts on an annual basis. 3. The office has in the past represented Dean and Iris Jacobson. They executed a living trust portfolio in 2007, before I commenced my employment with John Hatling. 4. In July 2010, I was reviewing the Jacobson’s file for the purpose of determining that all their assets were properly titled to their living trust. I was surprised to learn that a tract of real estate (Lot 18, Fair Oaks) was owned by the Jacobsons but was not titled to their living trust. I was concerned about this because of the possibility that the land would be subject to probate in the event the Jacobsons died. I contacted the Jacobsons to discuss this concern. Ultimately, they came to the office and signed the deed that conveyed Lot 18 to the trust; I then caused the deed to be filed with the Office of the Otter Tail County Recorder. 5. I have learned in the meantime that the Jacobsons intended that the tract not be conveyed to the trust because it would restrict their ability to sell the property if they so wished. 6. The titling of Lot 18 to the trust was a mistake; the Jacobsons had good reason to not convey the property to the trust. 7. I urge the Board of Adjustments to grant the petition for variance filed by the Jacobsons. FURTHER YOUR AFFIANT SAITH NAUGHT. , 2011Date: ^ Tricia A. Shaw Subscribed and sworn to before me, a No^ry Public, this^^^^day of S ^ , , 2m 1. Notar^JOHN A. HATLING | NOTTiRY PUBLIC ■ MINNESOTA | My Commission Expires Jan. 31,2015 > Affidavit of Diana Johnson 1. My name is Diana Johnson. I submit this affidavit in support of the application for a variance submitted by my parents, Dean and Iris Jacobson. 2. My parents originally purchased Lots 15, 16 and 17 in 1965 and a few years later acquired Lot 18 from my paternal grandmother who had purchased Lot 18 for her residence. All four lots had 75’ of lakeshore and less than 20,000 square feet of land but were the first lots to be sold on the southeast side of West Battle Lake and were the largest lots available. Lot 18 had a manufactured home that was tied down and had electricity, plumbing and heat for many years and my paternal grandmother lived there. Today the manufactured home has been removed but a shed remains on the property. 3. In 1992, my parents learned of a new Otter Tail County ordinance that required that they record the lots in separate names if they wanted to preserve the ability to sell each of the four lots as separate buildable lots. My parents went through the expense of having each of their lots recorded in separate names for that reason. Although I did not live at home in 1992,1 can still remember this because many neighbors on the lake were faced with the need to do the same thing and this became a topic of much discussion. 4. In 2005, my parents sold Lot 15 and a home was built on that lot. In 2007, my parents saw attorney John Hatling in order to have their will updated, .lohn recommended a revocable trust be prepared for my parents. My parents told John that they wanted to be sure that their ability to sell Lot 18 was preserved because they anticipated a need for the income in the future. In 2007, Lots 16 and 17, on which my parent’s home and garage are located, were placed into the trust. Lot 18 was left out to preserve the right to sell Lot 18 separately. 5. In 2008, my father, who always had managed all of the business for my parents, was diagnosed with Alzheimer’s disease and began treatment with Aricept for this very devastating disease; however, his cognitive abilities had declined dramatically and he no longer was able to make decisions. Shortly thereafter, my mother was diagnosed with depression, for which she now takes medication. Her cognitive abilities have also been affected accordingly. 6. In 2010, my mother received a call from Tricia Ohirogge, paralegal at John Hatling’s law office. She informed my mother that Lot 18 had been left out of the trust in error. Perhaps Tricia had misread the file or failed to notice the importance of preserving the salability of Lot 18. At that time, my mother really wasn’t sure what this meant but she was very alarmed and asked that the matter be fixed. Nobody told her that by doing this, she could be losing the privilege of selling Lot 18. Lot 18 was recorded as a part of the Jacobson trust on September 13, 2010. 7. In 2011 my mother decided to sell Lot 18 and secured the services of realtor Todd Ukkelberg, effective May 5, 201!. 8. Buyers Paul and Kris Kostelecky made an offer in June 2011 and the offer was accepted. The parties secured the services of N. F. Field Abstract Company to do the title search and prepare the paperwork for closing. The original closing date of August 15, 2011, was delayed because the title work was not complete and a new closing date of August 23, 2011, was scheduled. During the week before closing, my mother received a request for a certificate of trust and was also told about an additional fee for an easement for Otter Tail Power Company. Her recollection is fuzzy but she thinks she had several calls for various other pieces of information. The closing was completed on August 23rd and my mother used the proceeds to pay off the mortgage on their home on August 25th. 9. On August 29th my mother received a frantic call explaining that Otter Tail County was refusing to record the deed for the buyer because the lot could not be conveyed. I had not been involved with the sale of Lot 18 so this came as a shock to me. It seemed that if experts like Todd Ukkelberg and the Field Abstract Co. were unable to determine that Lot 18 was not salable, it would be impossible for a layman to understand this. This is especially true for a couple of 79 and 85 years, both of whom suffer from cognitive difficulties. 10. 1 called Wayne Stein and he explained their reasoning to me. He told me that it was regrettable that there was no form of mark on the county’s records that would have alerted the title company that the deed could not be recorded. He promised me that he was going to speak with various authorities within Otter Tail County to see if there would be a solution to this mistake. He also suggested the option of applying for a variance from the Board of Adjustments. 11. My mother was so upset and frightened by this matter that she fell that evening and had to be hospitalized. She has become quite depressed since then and has declined terribly. My father is completely confused and has no understanding of the seriousness of the situation in which they find themselves. 12. Prior to the sale of Lot 18, 1 had been attempting to arrange for assisted living care for my father, a daunting task in and of itself. This hardship has been incredibly difficult as my parents are in no condition to resolve the situation and I am attempting to assist from a distance. 13. It is clear that the recording of the deed on Lot 18 on September 13, 2011, less than a year before the sale, was an error. Therefore, it would be right and equitable for the Board to permit the variance requested in the petition. FURTHER YOUR AFFIANT SAITH NAUGHT. Date;, 2011 Diana L. Johjtson Subscribed and sworn to before me, a Notary Public, this day of , 2011. Notary Public CALIFORNIA JURAT WITH AFFIANT STATEMENT ^ See Attached Document (Notary to cross out lines 1-6 below) □ See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 2 (if any)Signature of Document Signer No. 1 State of California County of Subscribed and sworn to (or affirmed) before me on this ai ■Sj' fifi.'v') * Month ,20 // ,byr_ day of -L^ I CiL y\ ^ L* ^ ^ YearDate 1D 1-^(1). Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (,) (and ^ KATHUEEH OUVIA ORTIZ n Commlision # 1816407B Nottry Public • California 1 y RtwrcMa County f 1 (2). Name of Signer 1^proved to me on the basis of satisfactory evidence to be the person who appeared before me.) 0Jl £ ■t-.U c. Signature t Signature of Notary Public Place Notary Seal Above OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document RIGHTTHUMBPRINT OF SIGNER #2 RIGHTTHUMBPRINT OF SIGNER #i Top of thumb here Top of thumb here Title or Type of Document:. ‘t-i~i-\IDocument Date:Number of Pages: Signer(s) Other Than Named Above: ©2007 National Notary Association • 9350 De Soto Ave., P.O.Box 2402 • Chatsworth, CA 91313-2402-www.NationalNotary.org Item tf5910 Reorder: Call Toll-Free 1-800-876-6827 Sep 12 2011 6:56PM Dean Jacobson JR Dean Jacobson PO Box 9 41529 Ukkelberg Dr Clitherall.MN 56524 Dear Dean, To Wliom It May Concern This letter is to cettily that Dean Jacobson is an 85 year old male who is suffering from progressive decline in his mental abilities due to Alzheimer's Disease (331.0). The diagnosis was made in March of2008. Treatment has included Aricept and Namenda, which he has tolerated quite well, but his decline has been progressive and relatively rapid. He is no longer capable of being home alone safely, no longer drives and is barely able to assist with even minor chores around the home. He has developed worsening symptoms of Obcessive Compulsive tendencies and woiries about almost everything. Minor disruptions of his day cause significant anxiety and lead to much stress for his wife and family attempting to care for him at home. His wife. Iris, was diagnosed with Depression in 2008 as well. Her health is also failing, causing her level of anxiety to lead to loss of sleep and resulting in an emergency room visit for syncopy. This visit lead to Dean becoming overtly anxious, belieiving he did something to cause all of this. Dean and Iris are in need of additional assistance and will likely need to move to assisted living and eventually to an elder care facility. DanieIXembcke MD Battle Lake Clinic Affldavit of John A. Hatling 1. lam John A. Hatling, an attorney at law licensed to practice in the state of Minnesota. 2. I have in the past represented Dean and Iris Jacobson. I specifically represented the Jacobsons for the purpose of preparing an estate plan, which included a revocable living trust, in 2007. When the preparation of the trust document had been completed, the Jacobsons identified certain tracts of real property they owned (Lots 16, & 17, and 18, Fair Oaks), and asked for advice about the titling of same. We discussed the need to convey their homestead (Lots 16 and 17) to their trust. My office accordingly prepared a Quit Claim Deed that conveyed the homestead to the revocable living trust. I discussed with the Jacobsons the titling of an adjacent tract they owned (Lot 18); they specifically stated that Lot 18 should not be titled to the trust because of concerns about the Otter Tail County Shoreland Management ordinance. They stated that if their three tracts would all be titled to the trust that they would then be unable to sell Lot 18 separately. It was important to them to be able to sell Lot 18 alone if needed in the future. My office prepared a deed to convey Lots 16 and 17 to the trust; no deed was prepared that conveyed Lot 18 to the trust. It was intentionally not conveyed because of the stated concern about the titling of the tracts. 3. In July 2010, my paralegal, who was not employed by my office at the time I first met with the Jacobsons, learned that the Jacobsons still owned a tract of adjacent land that had not been conveyed to the Jacobson’s trust. She was rightfully concerned about the tract of land that was not to be titled to the trust. She called the Jacobsons to discuss this concern. Ultimately, the Jacobsons signed the deed that conveyed Lot 18 to the trust; my paralegal also caused the deed to be filed with the Office of the Otter Tail County Recorder. 4. I did not give the recorded deed another thought until I received a call from Diana Johnson, daughter of the Jacobsons. She stated that her parents had sold Lot 18, but that the Purchasers were unable to record the deed. Apparently, the county auditor would not approve the deed for recording because it was contiguous to the other tracts similarly titled. 5. I am convinced that the deed conveying Lot 18 to the Jacobsons’ revocable living trust was recorded erroneously. The Jacobsons had at one time advised my office that Lot 18 should not be conveyed to the trust, because to do so would restrict the sale of that tract.. The deed would still not be recorded were it not for a diligent and well intentioned (but mistaken) paralegal, who was simply taking steps to ensure that our clients’ affair were all in order. As it is, a good faith purchaser has been left unable to record the deed that memorializes their purchase. The Jacobsons and the Purchasers are both left in a very difficult position if the petition for variance is not granted. 6. The Board of Adjustments should recognize that a mistake has been made and permit the petition for variance. Lot 18 should not have been conveyed to the Jacobson trust; but for the mistaken conveyance, the good faith purchasers could have recorded their deed without any hesitation. FURTHER YOUR AFFIANT SAITH NAUGHT. /•> Date;h , 2011 ohn A Hatling Subscribed and sworn to be&r a ^tary Pijblic, tljis re me, day of ,2011. Ubl TRICIA A. OHLROGGE | NOTARY PUBLIC - MINNESOTA | ^'yCorr^- Exp, Jan 31,2014 | . -.-J - • Af Affidavit of Tricia A. Shaw I am Tricia A. Shaw; I am a paralegal employed by the office of attorney John A. Hatling.1. I am employed by a general practice law firm; the firm prepares a number of estate planning portfolios and living trusts on an annual basis. 2. The office has in the past represented Dean and Iris Jacobson. They executed a living trust portfolio in 2007, before I commenced my employment with John Hatling. 3. In July 2010, I was reviewing the Jacobson’s file for the purpose of determining that all their assets were properly titled to their living trust. I was surprised to learn that a tract of real estate (Lot 18, Fair Oaks) was owned by the Jacobsons but was not titled to their living trust. I was concerned about this because of the possibility that the land would be subject to probate in the event the Jacobsons died. I contacted the Jacobsons to discuss this concern. Ultimately, they came to the office and signed the deed that conveyed Lot 18 to the trust; I then caused the deed to be filed with the Office of the Otter Tail County Recorder. 4. I have learned in the meantime that the Jacobsons intended that the tract not be conveyed to the trust because it would restrict their ability to sell the property if they so wished. 5. The titling of Lot 18 to the trust was a mistake; the Jacobsons had good reason to not convey the property to the trust. 6. I urge the Board of Adjustments to grant the petition for variance filed by the Jacobsons.7. FURTHER YOUR AFFIANT SAITH NAUGHT. , 2011Date: " Tricia A. Shaw Subscribed and sworn to before me. a No^ry Public, this day of S ; . 2m 1. Notar^u^ic h JOHN A. HATLING P NOTARY PUBLIC - MINNESOTA ^ My Commission Expires Jan. 31,2015 Affidavit of Diana Johnson I. My name is Diana Johnson. I submit this affidavit in support of the application for a variance submitted by my parents, Dean and Iris Jacobson. 2. My parents originally purchased Lots 15, 16 and 17 in 1965 and a few years later acquired Lot 18 from my paternal grandmother who had purchased Lot 18 for her residence. All four lots had 75’ of lakeshore and less than 20,000 square feet of land but were the first lots to be sold on the southeast side of West Battle Lake and were the largest lots available. Lot 18 had a manufactured home that was tied down and had electricity, plumbing and heat for many years and my paternal grandmother lived there. Today the manufactured home has been removed but a shed remains on the property. 3. In 1992, my parents learned of a new Otter Tail County ordinance that required that they record the lots in separate names if they wanted to preserve the ability to sell each of the four lots as separate buildable lots. My parents went through the expense of having each of their lots recorded in separate names for that reason. Although 1 did not live at home in 1992,1 can still remember this because many neighbors on the lake were faced with the need to do the same thing and this became a topic of much discussion. 4. In 2005, my parents sold Lot 15 and a home was built on that lot. In 2007, my parents saw attorney John Hatling in order to have their will updated. John recommended a revocable trust be prepared for my parents. My parents told John that they wanted to be sure that their ability to sell Lot 18 was preserved because they anticipated a need for the income in the future. In 2007, Lots 16 and 17, on which my parent’s home and garage are located, were placed into the trust. Lot 18 was left out to preserve the right to sell Lot 18 separately. 5. In 2008, my father, who always had managed all of the business for my parents, was diagnosed with Alzheimer’s disease and began treatment with Aricept for this very devastating disease; however, his cognitive abilities had declined dramatically and he no longer was able to make decisions. Shortly thereafter, my mother was diagnosed with depression, for which she now takes medication. Her cognitive abilities have also been affected accordingly. 6. In 2010, my mother received a call from Tricia Ohlrogge, paralegal at John Hatling’s law office. She informed my mother that Lot 18 had been left out of the trust in error. Perhaps Tricia had misread the file or failed to notice the importance of preserving the salability of Lot 18. At that time, my mother really wasn’t sure what this meant but she was very alarmed and asked that the matter be fixed. Nobody told her that by doing this, she could be losing the privilege of selling Lot 18. Lot 18 was recorded as a part of the Jacobson trust on September 13,2010. 7. In 2011 my mother decided to sell Lot 18 and secured the services of realtor Todd Ukkelberg, effective May 5, 2011. 8. Buyers Paul and Kris Kostelecky made an offer in June 2011 and the offer was accepted. The parties secured the services of N. F. Field Abstract Company to do the title search and prepare the paperwork for closing. The original closing date of August 15, 2011, was delayed because the title work was not complete and a new closing date of August 23, 2011, was scheduled. During the week before closing, my mother received a request for a certificate of trust and was also told about an additional fee for an easement for Otter Tail Power Company. Her recollection is fuzzy but she thinks she had several calls for various other pieces of information. The closing was completed on August 23rd and my mother used the proceeds to pay off the mortgage on their home on August 25th. 9. On August 29th my mother received a frantic call explaining that Otter Tail County was refusing to record the deed for the buyer because the lot could not be conveyed. T had not been involved with the sale of Lot 18 so this came as a shock to me. It seemed that if experts like Todd Ukkelberg and the Field Abstract Co. were unable to determine that Lot 18 was not salable, it would be impossible for a layman to understand this. This is especially true for a couple of 79 and 85 years, both of whom suffer from cognitive difficulties. 10. I called Wayne Stein and he explained their reasoning to me. He told me that it was regrettable that there was no form of mark on the county’s records that would have alerted the title company that the deed could not be recorded. He promised me that he was going to speak with various authorities within Otter Tail County to see if there would be a solution to this mistake. He also suggested the option of applying for a variance from the Board of Adjustments. 11. My mother was so upset and frightened by this matter that she fell that evening and had to be hospitalized. She has become quite depressed since then and has declined terribly. My father is completely confused and has no understanding of the seriousness of the situation in which they find themselves. 12. Prior to the sale of Lot 18, I had been attempting to arrange for assisted living care for my father, a daunting task in and of itself This hardship has been incredibly difficult as my parents are in no condition to resolve the situation and I am attempting to assist from a distance. 13. It is clear that the recording of the deed on Lot 18 on September 13, 2011, less than a year before the sale, was an error. Therefore, it would be right and equitable for the Board to permit the variance requested in the petition. FURTHER YOUR AFFIANT SAITH NAUGHT. Date;,2011 Diana L. Johnson Subscribed and sworn to before me, a Notary Public, this day of , 2011. Notary Public C CALIFORNIA JURAT WITH AFFIANT STATEMENT ^ See Attached Document (Notary to cross out lines 1-6 below) □ See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 1 Signature of Document Signer No. 2 (if any) State of California County of Subscribed and sworn to (or affirmed) before me on this Le r . 20 II . by * MontFi V i o K n A _day of I Cl i/\ ^ ^^ ^ Date Year (1). Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (,) (and KATHUEEN OLiViA ORTIZ Conmlision # 1816407 Notary PobUc - Califomia § RiyareMa County ^ (2). Name of Signer i proved to me on the basis of satisfactory evidence to be the person who appeared before me.) 1 a.Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document Further Description of Any Attached Document RIGHT THUMBPRINT OF SIGNER #i RIGHTTHUMBPRINT OF SIGNER #2 Top of thumb here Top of thumb here Title or Type of Document:. Q_Document Date:Number of Pages; Signer(s) Other Than Named Above: ©2007 National Notary Association • 9350 De Soto Ave., P.O. Box 2402*Chatsworth, CA 91313-2402 •www.NationalNotary.org Item #5910 Reorder Cali Toll-Free 1-800-876-6827 Sep 12 2011 6:56PM Dean Jacobson JR Dean Jacobson PO Box 9 41529 UkkelbergDr CIitherall,MN 56524 Dear Dean, To Wliom It May Concern This letter is to certily that Dean Jacobson is an 85 year old male who is suffering from progressive decline in his mental abilities due to Alzheimer's Disease (331.0). The diagnosis was made in March of 2008. Treatment has included Aricept and Namenda, which he has tolerated quite well, but his decline has been progressive and relatively rapid. He is no longer capable of being home alone safely, no longer drives and is barely able to assist with even minor chores around the home. He has developed worsening symptoms of Obcessive Compulsive tendencies and worries about almost everything. Minor disruptions of his day cause significant anxiety and lead to much stress for his wife and family attempting to care for him at home. His wife. Iris, was diagnosed with Depression in 2008 as well. Her health is also failing, causing her level of anxiety to lead to loss of sleep and resulting in an emergency room visit for syncopy. This visit lead to Dean becoming overtly anxious, belieiving he did something to cause all of this. 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T cn<- & ■ ■ I C\ J-\ 0 O S L. 'SXt I/-,/'j c) J) ■Pyi- .C' ■ z J L n >Z0 z I 0 y. f-P - i f'/ J 0 „ XD ,i< 12 c '^' '^1 plAt f 0 Art\ (/?£>n(!)i/Ei)} jC £ AAAJ ^—p A- T (0 iiD£ waU^- 6 S'£. 'A l'P‘~ljtt^^ ''0 L XO')sc 7'-I -T2t ) -7^pA-yilH O^i'^0 p /v-r vr pyT'-t 'F’O [ ^ ^(Ai^A-!ir£ I -To pf/prOi-i^r"—D I 6 Affldavit of John A. Hatling 1. I am Jolm A. Hatling, an attorney at law licensed to practice in the state of Minnesota. 2. I have in the past represented Dean and Iris Jacobson. I specifically represented the Jacobsons for the purpose of preparing an estate plan, which included a revocable living trust, in 2007. When the preparation of the trust document had been completed, the Jacobsons identified certain tracts of real property they owned (Lots 16, & 17, and 18, Fair Oaks), and asked for advice about the titling of same. We discussed the need to convey their horhestead (Lots 16 and 17) to their trust. My office accordingly prepared a Quit Claim Deed that conveyed the homestead to the revocable living trust. I discussed with the Jacobsons the titling of an adjacent tract they owned (Lot 18); they specifically stated that Lot 18 should not be titled to the trust because of concerns about the Otter Tail County Shoreland Management ordinance. They stated that if their three tracts would all be titled to the trust that they would then be unable to sell Lot 18 separately. It was important to them to be able to sell Lot 18 alone if needed in the future. My office prepared a deed to convey Lots 16 and 17 to the trust; no deed was prepared that conveyed Lot 18 to the trust. It was intentionally not conveyed because of the stated concern about the titling of the tracts. 3. In July 2010, my paralegal, who was not employed by my office at the time I first met with the Jacobsons, learned that the Jacobsons still owned a tract of adjacent land that had not been conveyed to the Jacobson’s trust. She was rightfully concerned about the tract of land that was not to be titled to the trust. She called the Jacobsons to discuss this concern. Ultimately, the Jacobsons signed the deed that conveyed Lot 18 to the trust; my paralegal also caused the deed to be filed with the Office of the Otter Tail County Recorder. 4. I did not give the recorded deed another thought until I received a call from Diana Johnson, daughter of the Jacobsons. She stated that her parents had sold Lot 18, but that the Purchasers were unable to record the deed. Apparently, the county auditor would not approve the deed for recording because it was contiguous to the other tracts similarly titled. 5. I am convinced that the deed conveying Lot 18 to the Jacobsons’ revocable living trust was recorded erroneously. The Jacobsons had at one time advised my office that Lot 18 should not be conveyed to the trust, because to do so would restrict the sale of that tract.. The deed would still not be recorded were it not for a diligent and well intentioned (but mistaken) paralegal, who was simply taking steps to ensure that our clients’ affair were all in order. As it is, a good faith purchaser has been left unable to record the deed that memorializes their purchase. The Jacobsons and the Purchasers are both left in a very difficult position if the petition for variance is not granted. 6. The Board of Adjustments should recognize that a mistake has been made and permit the petition for variance. Lot 18 should not have been conveyed to the Jacobson trust; but for the mistaken conveyance, the good faith purchasers could have recorded their deed without any hesitation. FURTHER YOUR AFFIANT SAITH NAUGHT. .2011Date: Ibhn A Hatling Subscribed and sworn to b^fj^re me, day of 2011. TRICIA A. 0HLR06GE I I] NOTARY PUBLIC-MINNESOTA | ' My Comm, Exp, Jan, 31,2014 y Affldavit of Tricia A. Shaw 1. lam Tricia A. Shaw; I am a paralegal employed by the office of attorney John A. Hatling. 2. I am employed by a general practice law firm; the firm prepares a number of estate planning portfolios and living trusts on an annual basis. 3. The office has in the past represented Dean and Iris Jacobson. They exeeuted a living trust portfolio in 2007, before I commenced my employinent with John Hatling. 4. In July 2010, I was reviewing the Jacobson’s file for the purpose of determining that all their assets were properly titled to their living trust. T was surprised to learn that a tract of real estate (Lot 18, Fair Oaks) was owned by the Jacobsons but was not titled to their living trust. I was eoncemed about this because of the possibility that the land would be subject to probate in the event the Jacobsons died. I contacted the Jacobsons to discuss this concern. Ultimately, they came to the office and signed the deed that conveyed Lot 18 to the trust; I then caused the deed to be filed with the Office of the Otter Tail County Recorder. •5. I have learned in the meantime that the Jacobsons intended that the tract not be conveyed to the trust because it would restrict their ability to sell the property if they so wished. 6. The titling of Lot 18 to the trust was a mistake; the Jacobsons had good reason to not convey the property to the trust. 7. I urge the Board of Adjustments to grant the petition for variance filed by the Jacobsons. FURTHER YOUR AFFIANT SAITH NAUGHT. .,2011Date: Tricia A. Shaw Subscribed and sworn to before me, a N^ry Public, this<^^^day of xsassssssissis^iasssi JOHN A. HATLINGNOTARY PUBLIC-MINNESOTA | My Commission Expires Jan. 31,2015 ^ Notarv^mic Affldavit of Diana Johnson 1. My name is Diana Johnson. T submit this affidavit in support of the application for a-yariance submitted by my parents, Dean and Iris Jacobson. 2. My parents originally purchased.Lots 15, 16 and 17 in 1965 and a few years later acquired Lot 18 from my paternal grandmother who had purchased Lot 18 for her residence. All four lots had 75’ of lakeshore and less than 20,000 square feet of land but were the first lots to be sold on the southeast: side of West Battle Lake and were the largest lots available. Lot 18 had/ a manufactured home that was tied down and had electricity, plumbing and heat for many years and my paternal grandmother lived there. Today the manufactured home has been removed but a shed remains on the property. 3. In 1992, my parents learned of a new Otter Tail County ordinance that required that they record the lots in separate names if they wanted to preserve the ability to sell each of the four lots as separate buildable lots. My parents went through the expense of having each of their lots recorded in separate names for that reason. Although I did not live at home in 1992,1 can still remember this because many neighbors on the lake were faced with the need to do the same thing and this became a topic of much discussion. 4. In 2005, my parents soldrLot 15 and a home was built on that lot. In 2007, my parents saw attorney John Hatling in order to have their will updated. John recommended a revocable trust be prepared for my parents. My parents told John that they wanted to be sure that their ability to sell Lot l 8 was preserved because they anticipated a need for the income.in the future. In 2007, Lots 16 and 17, on which'my parent’s home and garage are located; were placed into the trust. Lot 18 was: left out to preserve the right to sell Lot 18 separately. 5. In 2008, my father, who always had managed all of the business for my parents, was diagnosed with Alzheimer’s disease and began treatment with Aricept for this yery devastating disease; however, his cognitive abilities had declined dramatically and he no longer was able to make decisions. Shortly thereafter, my mother was diagnosed with depression, for which she now takes medication. Her cognitive abilities have also been affected accordingly. 6. In 2010, my mother received a call from Tricia OhlrpggCi paralegal at John Ratling’s law office. She informed my mother that Lot 18 had been left out of the trust in error. Perhaps Tricia had misread the file or failed to notice the importance of preserving the salability of Lot 18. At that time, my mother really wasnft sure what this meant but she was very alarmed and asked that the matter be fixed. Nobody told her that by doing this, she could be losing the privilege of selling Lot 18. Lot 18 was recorded as a part of the Jacobson trust on September 13,2010. • .<■ 7. In 2011 my mother decided to sell Lot 18 and secured the services of realtor Todd Ukkelberg, effective May 5, 2011. 8. Buyers Paul and Kris Kostelecky made an offer in June 2011 and the offer was accepted. The parties secured the services of N; F. Field Abstract Company to do the titler:search and prepare the paperwork for closing. The original closing date of August 15, 2011, was delayed because the title work was not complete and a new closing date of August 23, 2011, was scheduled. During the week before closing, my mother received a request for a certificate of trust and was also fold about an additional fee for an easement for Otter Tail Power Corhpany. Her recollection is ftizzy buf she thinks she had several calls for various other pieces of information. The closing was completed on August 23rd arid my mother used the proceeds to pay off the mortgage on their home on August 25th. 9. -On August 29th my mother received a frantic call explaining that Otter Tail County was refusing to record the deed for the buyer because the lot could not be conveyed. I had not beeri irivolved with the sale of Lot 18 soThis came as a shock to me. It seemed that if experts like Todd.Ukkelberg and the Field Abstract Co. were unable to determine that Lot 18 was not salable, it would be impossible for a layman to understand this. This is especially true for a couple of 79 and 85 years, both of whom suffer from cognitive difficulties. fO:l called Wayne Stein and he explained-their reasoning to me. He told me that it was regrettable that there was no form of mark on the county’s records that would have alerted the title company that the deed could not be recorded. He promised me that he was going to " speak with various authorities within OtterTail County to see if there would be a solution to this mistake. He also suggested the option of applying for a variance from the Board of Adjustments. 11. My mother was so upset and frightened by this matter that she fell that evening and had to be hospitalized. She has become quite depressed since then and has declined terribly. My father is completely confused and has no understanding of the seriousness of the situation in which they find themselves. j 12. Prior to the sale of Lot 18, I had been attempting to arrange for assisted living care for my father, a daunting task in and of itself This hardship has been incredibly difficult as my parents are in no condition to resolve the situation and I am attempting to assist from a distance. '.r 13. It is clear that’the recording of the deed on Lot 18 on September 13, 2011, less than a year before the sale, was an error. Therefore, it would be right and equitable for the Board to permit the variance requested in the petition. FURTHER YOUR AFFIANT S AITH NAUGHT. Date:,2011 LyDiana L. Johnson Subscribed and sworn to before me, a Notary Public, this day of ,2011. Notary Public CALIFORNIA JURAT WITH AFFIANT STATEMENT ^ See Attached Document (Notary to cross out lines 1-6 below) □ See Statement Below (Lines 1-5 to be completed only by document signer[s], not Notary) Signature of Document Signer No. 2 (if any)Signature of Document Signer No. 1 State of California /?! \i ^ r c ICounty of Subscribed and sworn to (or affirmed) before me on this 20 // ■ by YearanSj> ^ * Month day of _ (11 Date L dd.-^ (D W nj;n /A Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me (.) (,) (and __________ M^SStOLMAmrlz CMMiNiM # 1I16407 (2). Name of Signer proved to me on the basis of satisfactory evidence to be the person who appeared before me.)WwraMi CoHy 5 Signature A Signature of Notary Public Place Notary Seat Above OPTIONAL Though the information below is not required by law, it may prove valuable to persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. Further Description of Any Attached Document RIGHT THUMBPRINT OF SIGNER #1 RIGHT THUMBPRINT OF SIGNER #2 Top of thumb here Top of thumb here Title or Type of Document:. g,: t-z2D-U Q_Document Date:Number of Pages: Signer(s) Other Than Named Above: ©2007 National Notary Association* 9350 De Soto Ave., PO. Box 2402*Chatsworth, CA 91313-2402-www.NationalNotary.org ttem #59t0 Reorder: Call Toll-Free 1-800-876-6827 f - Sep 12 2011 6:56PM Dean Jacobson JR Dean Jacobson PO Box 9 41529.UkkelbergDr CIitherall,MN 56524 Dear Dean, To Wliom It May Concern This letter is to certify that Dean Jacobson is an 85 year old male who is suffering from progress!ve decline in his mental abilities due to Alzheimer's Disease (331.0). The diagnosis was made in March of 2008. Treatment has included Aricept and Namenda, which he has tolerated quite well, but his decline has been progressive and relatively rapid. 'He is no longer capable of being home alone safely, no longer drives and is barely able to assist with even minor chores around the home. He has developed worsening symptoms of Obcessive Compulsive tendencies and worries about almost evei^thing. Minor disriiptions,of his day cause signiRcant anxiety and lead to much stress for his wife and family attempting to care for him at home. His wife. Iris, was diagnosed with Depression in 2008 as well. Her health is also failing, causing her level of anxiety to lead to loss of sleep and resulting in an emergency room visit for syncopy. This visit lead to Dean becoming overtly anxious, belieiving he did something to cause all of this. Dean and Iris are in need of additional assistance and will likely need to move to assisted living and eventually to an elder care facility. .'.1 I; ! ■ ; "I Daniel'Lembcke MD Battle Lake Clinic i ...i.I SCAIIE DRAWING! FORM ]■ ‘.I IiI1 I ' /'/ - Z/';00 n'-'‘0 J Ig-0 f (,0,3 no 0 I•-)')')/'I Tax Parcel Number(s) The scale drawing must be a signed drawing which includes and identifies a graphic scale (feet), all existing and/or proposed structures, septic tanks, drainfields, lotlines, road right-of-ways, easements, OHWLs, wells, wetlands, topographic features (i.e. bluffs), and onsite impervious surface calculations. /.1.7 7 ^7 I ' j.1 fclkJ-r-Scale Impervious Surface Ratio (Must Complete Worksheet On Other Side) Itj ; ! 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