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3/2021 Owner Parcel # Mailing Address Permit # City Date Submitted State, Zip 60 Days Day Phone Fee Cell Phone Date of Hearing: Email Property Address Subdivision Twp Section______ Applicant Applicant Same as Owner Name Address 1 Address 2 City State, Zip Email Day Phone Clay County Planning & Zoning 3510 12th Avenue South, PO Box 280 Moorhead, MN 56561-0280 Tel (218) 299-5005 Fee $225.00 Variance Permit Application ---PAGE BREAK--- 3/2021 1. Explain how you wish to vary from the provisions of the Clay County Land Development Ordinance: 2. Explain the hardship or practical difficulty imposed if strict application of the ordinance is imposed: 3. Check all additional supporting documents and data which are being submitted to help explain this project: ❑ Sketch Plan ❑ Topographical Map ❑ Detailed Narrative ❑ Operation plans ❑ Engineering plans ❑ Flood Plain Hydraulic Analysis ❑ Flood Proofing Plans & Specs ❑ Others (specify) To the best of my knowledge, I certify that the information provided on this application and accompanying documents is true and accurate. Applicant signature: