HomeMy WebLinkAbout17000991192000_Variances_09-20-1972White — Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Phone No.Owner:
Last Name MiddleFirst
Citv rStreet & No.
jL "2^^—State Zip No.
76t
Legal Description: Lake No..Lake Name Lake Class
Twp. ^ Range ^ Uj ^Sec.Twp. Nama
.e'
If applicant is a corporation, what state incorporated in____
Applicant is: ( ) 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 conditons found in
what Section of the Ordinance:_____
EXPLAIN YOUR PROBLEM HERE:
z;
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
19 . XApplication dated.
Signature of Applicant
—DO NOT USE SPACE BELOW—
19_^^9-Date application filed with Shoreland Management Administration.
Deviation requires: Planning Commmission approval ( ) Shoreland Management approval only ( )BolfKj )
ByFiling acknowledgement Signature
day of_^epTL79 7^ W!TH THE FOLLOWING
£M
rO-ODEVIATION APPROVED this______
(ORATTACHED) REQUIREMENTS:
L. IjCLAjU- Ccp.^:iA.oO<,Jl
Frank AIttadt, President
Otter Tail Planning Advisory Commission
Signature.
Deviation
Approved this /5-^K^TO^^ore^n5^l^ldnagement Administrator19^2^ By.y?/>day of.Matcol
Otter Tbil County, MinnesotaMKL-0871-016
159079
viCTOM uaeccii « CO . POiHTttto. rioowt rM.L«. mioo
L GRID PLOT PLAN SKETCHING FORM.feet/inches.Scale: Each grid equals
19 9^Mr. & Mrs. M. E. Wambach
Rural Route 3
Pelican Rapids, Minn. S6S72
Application for Building Permit Dated.
Application for Sewage System Permit Dated .19
Sewage System Permit Number.Building Permit Number
Applicant agrees that this plot plan is a part of application (s) indicated above.
;
.19.2^Dated.
S ignatu re
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