HomeMy WebLinkAbout17000991049000_Variances_05-03-1978White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
La^l^ameOwner:_Phone No.
rFirst Middle
/ //e&»c 4&^
Street & No.City State Zip No.
A f>Legal Description: Lake O Lake Name Lake Class
4O?0 A2ZSec.tLt\Twp.Range Twp. Name.
If applicant is a corporation, what state incorporated in____
Applicant is: ^<6 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
what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:
ti AALa’ ^
ni^lease provide as much su lementary information as possible, such as: maps.In order to properly evaluate the situatio
plans, information about surrounding property, etc.
JApplication dated . X
of ApplicantT3/-7 —DO NOT USE SPACE BELOW
19 ^
Date application filed with Shordland Management Administratioa
Deviation requires: Planning Commmission approval { ) Shoreland Management approval only ( ) Both ------
Filing acknowledgement By
Signature
3d!> P. /A ^ Onvi5'- £ ~Date, time and place of hearing
DEVIATION APPROVED this
(OR ATTACHED) REQUIREMENTS:
*3 yi_W!TH THE FOLLOWINGday oT .. 19.
- 7F
Signature
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19 • By.Malcolm K, Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL0871016
171988-A(g)
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GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
.19.Application for Building Permit Dated_____
Application for Sewage System Permit Dated
T
19
+Sewage System Permit Number.Building Permit Number.
Applicant agrees that this plot plan is a part of application (s) indicated above.!t'T
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19.Dated.Signature
’6sent builditigall
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Indicate all pifd™ p?o^Lrbunkgs or additions
Also indicate in feet; lake setback, side yard s
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setback.
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