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APPLICATION FOR VARIANCE
FROM
OTTER TAIL COUNTY, MINNESOTA
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/d^Application Fee $
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__________________________
Owner:MiddleFirstLast Name
*Oao->jm. g-Rfet-U.fe. I City State Zip No.Street & No.
(ilA.)£IclqJp 54 53Lake ClassLake NameLake No.
Ho ^jd. ^ le )"~o^\4g..l±m Twp, NameRangeTwp.Sec.
Legal Description:Lot No.Block No./oT / /
Sub-Division Name:
Parcel Number
Explain your problem here:^ / / OnA- / k
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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. APPLICI ANT SHALL BE PRESENT AT THE SCHEDULED HEAR ING.
l£ .xV^J2^ryJiy19.Application dated.
Signature of Applicant
— DO NOT USE SPACE BELOW—
19^**^ Time______ At.Date of hearing
Court House, Fergus Falls, MN. 56537
day ot 19.WITH THE FOLLOWINGDEVIATION APPROVED this_____
(OR A TTACHED) REQUIREMENTS:
Signature:
Chairman
Otter Tail Board of AdjustmentMKL 0483 -OOt
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