HomeMy WebLinkAbout17000991229000_Variances_04-06-1975White - Office
Yellow — Owner
Pink — Township
APPLICATION FOR VARIANCE
FROM
Requirements of Shoreland Management Ordinances Otter Tail County, Minnesota
Phone No, — ^ ^ ^
^ Last Name ^ First Middle
StreeTsTNoT" Citv X
Owner:
^xl). 5T / o t-'
State Zip No.
Sr-~7C^Legal Description: Lake No..Lake Name Lake Class
Twp. _/ 3 7Sec.Range Twp. Nam&
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:
7.
a.7
In order to properly evaluate the situation, please provide as much supplementary information as possible, such as: maps,
plans, information about surrounding property, etc.
^ Signature of Applicant
fii YLApplication dated 19.. X
— DO NOT USE SPACE BELOW—
1927Date application filed with Shoreland Management Administration
Deviation requires: Planning Commmission approval Shoreland Management approval only ( ) Both ( )
xf.Filing acknowledgement By Signature
pate, time and place of hearing.
DEVIATION APPROVED this_____
(OR ATTACHED) REQUIREMENTS:
day of_19____WITH THE FOLLOWING
REJECTO By ^WtbA flrru -Yr/rj
T O/n .
Y..Doted:1 Initials '^^<4
Signature
Chairman
Otter Tail Planning Advisory Commission
Deviation
Approved this day of.19.. By-
Malcolm K. Lee, Shoreland Management Administrator
Otter Tail County, MinnesotaMKL0871-016
171988-A®
VICTOR uiNoccH 00.. MiNraoi. riROuo rii.Li. minn.
GRID PLOT PLAN SKETCHING FORM j.feet/inches.
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.
Scale: Each grid equals^
4
.19.; tT
19
Sewage System Permit Number.I'
19.Dated Signature
On this form make a drawing of your lot.Indicate all present buildings with solid lines and all proposed buildings or additions with dotted lines. Also indicate'|in feet; lake setback, yard setback end rear
yard setback. ^-t-
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