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57283'^!APPLICATION FOR CONDITIONAL USE PERMIT
Shoreland Management Ordinance
Otter Tail County
Fergus Falls, Minnesota 56537
/0¥0S9Receipt No.
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Owner:Phone:
Last Name First Middle
£Ql Sox )71 mA.Street & No.City State Zip No.
-3 c-:?39
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Lake No.Lake Name Lake Class
39 (S /' j€ /}- if? ASec.Range Twp. Name
Legal Description:
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V Office of County Recorder
County of O^er Tail
I her«l)y certify that Sia w.thin instrument was filed
for record in this office on the ^ I day of
diYj was duly Microfilmed as Doc. « •
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EXPLAIN YOUR REQUEST:
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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. APPLICIANT SHALL BE PRESENT AT THE SCHEDULED HEARING.
I understand that I have applied for a Conditional Use Permit from Otter Tail County.
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Signature Of Applicant
19 . XApplication dated
- DO NOT USE SPACE BELOW -
19Date of hearing:
This application is hereby recommended for
VENJEV: R&o6on6 - 1. The potential ion eAo&lon.
1. Appnoval maid iet an undej>tnable pneced&nt In Chairman
thli anza. 3. Would be a poiilbiLUy oi change In diuu.ndge.
4. Thl6 type oi a cut contnany to the pa&t necommendattoni o
5. The dnawtng indicated the poi>i>lbiLity oi a bluU zone.
The Board of County Commissioners of Otter Tail County hereby
19 ------.
Time:i_M
by the Otter Tail County Planning Commission (Motion as follows).
approval denial
uthis Coml66ton.
this request (Motion as follows).deniesapproves
This day of 1
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Conditional Use Permit issued in accordance with compliance with existing Conditional Requirements and Special Regulations and
Minnesota Commissioner of Natural Resources notified this.day of.19
CONDITIONAL USE PERMIT NO..
Land & Resource Management Official
Otter Tail County, Minnesota
mailed copy of Application to Applicant.(Date/lnitial)
MKL — 0390-006
253.614 — Vidor Lundeen Co.. Printers, Fergus Falls. Minnesota
Scale: Each grid equals feet/inches GRID PLOT PLAN SKETCHING FORM
Dated:19
Signature
Please sketch your lot indicating setbacks from road right-of-way'lake andKsideyard for each building currently
on lot and any proposed structures.■E
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