HomeMy WebLinkAbout17000991139000_Variances_05-02-1973White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland l\^nagement Ordinances Otter Tail County, Minnesota
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Last Name
Phone NoOwner:O Middle
Afe> so-City State Zip No.Street 8i No.
2.; g3 ^ PLegal Description: Lake No.,Lake Name Lake Class
n^JL/3>Twp.Range Twp. Name.Sec.
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If applicant is a corporation, what state incorporated in____
Applicant is: ( ) Owner ( ) Lessee ( ) Occupant
1( ) 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 conditons found in
what 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.Ske '^c, k>f ^ dcu i /f he./
19 >3 .Application dated
Signature of Applicant
— DO NOT USE SPACE BELOW—
4-f(oDate application filed with Shoreland Management Administratioa
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( ) BothH-' )
ByFiling acknowledgement___________________________
:Date, time and place of hearing A ~<A ~ ^
Signature
WITH THE FOlUdWING
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/?'"hna ___19.
0
day of_DEVIATION APPROVED this______
(OR ATTACHED) REQUIREMENTS:
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P»enh AUtadt, Proaidont
Otter Tail Planning Advisory commission
Signature.
Deviation
Approved this 19 By.J 7day of.
Malcolm K. Lee, Shoreland Management Adminj^rator
Otter Tail County, MinnesotaMKL-0871-016
VICTOR wroccn & CO . oRiauao. fcosut fACLS.
150079
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GRID PLOT PLAN SKETCHING FORM.feet/inches.Sca/e; Each’grid equals
Application for Building Permit Dated_____
Application for Sewage System Permit Dated
Building Permit Number_________________
Applicant agrees that this plot plan is a part of application (s) indicated above.
.19.
.19
Sewage System Permit Number.
Dated.Signature
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