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2
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White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
La
Miiklle Phone No.Owner:
Last Name First
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StateStreet & No.Zip No.PvpT.
'■5~^ <^3 7 Lake Name ^3 ■ dlAJ—^isiLegal Description: Lake No..
Sec.
Lake Class
1 Range 3 7Twp.Twp. Name,
If applicant is a corporation, what state incorporated in____
Applicantls?T~') 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 conditonsfound in
-ToJUIsl ^ithcLoJbwhat 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.
% ,x19.Application dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
i/-cSa 19Date application filed with Shoreland Management Administration.
BcvfTTK))Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )
Filing acknowledgement By
Signature
Q ■>:io P/r\. F.F vnn.Date, time and place of hearing
DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
19____W! TH THE FOL L OWINGday of_
. ; r-u S*4
i‘‘. Li4.' if.'a Cl ■ J> i A'
^JoAfunxcocy -Q
______S thil5 -5
Signature
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19 . By.Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL-0871-016
171988-A®
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