HomeMy WebLinkAbout17000310370005_Variances_05-22-1972WhJte - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Phono No,Owner:; /Last Name MiddleFirst
^ \jV\A .
City State Zip No.Street & No.
F)/n- VLoLegal Description: Lake No..Lake Name Lake Class
dJ Twp. NameSec.Twp.Range
O'S.'S.
If applicant is a corporation, what state incorporated in___
Applicant is: (wTOwner ( ) Lessee ( ) Occupant ( ) Agent
Qa List Partner's name and address below:Is Applicant a partnership
VOS 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 condltons found In
what Section of the Ordinance: Q
EXPLAIN YOUR PROBLEM HERE:
J^Ujl P
I O-A-K, ■
In order to properly evalu^e the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
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Signature of Applicant
Bia iq7^. XApplication dated.
—DO NOT USE SPACE BELOW—
19___Date application filed with Shoreland Management Administration_____________________________
Deviation requires: Planning Commmission approval ( } Shoreland Management approval only ( )Both ( )
By.Filing acknowledgement Signature
Date, time and place of hearing
., 19____WITH THE FOLLOWINGDEVIATION APPROVED this_____
(OR A TTACHEDI REOU!REMENTS:
day ot
REJECTED R. Q-C.
L - 7Dated:^ 19-^lnltlali
Signature.
Frank Alstadt, President
Otter Tall Planning Advisory Commission
Deviation
Approved this 19____By.day of.
Malcolm K. Lee, Shoreland Management Administrator
Otter Tall County, MinnesotaMKL-0871-016
159079
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1 feet/inches | ! U i ! ! GRID PLOT PLAN SKETCHING FORM
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Applic^tiori |or Building Permit Dated.
I Application for Sewage System Perrhit Dated_^
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' Building Permit Number_i_!
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M.! Sewage System Perrhit hlumber_!
AjDplicant agrees thiat this plot plan is a part of application (s) indicated above. I i I ! !
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