Name Date
Address License
  Licensor
Phone:    
Question Condition Met Condition Not Met
This variance request is not retroactive.
I have been licensed for at least one year.
The variance is for 90 days or less.
I have not had a variance within the past 12 months.
I will not be caring for more than 3 infants at any time.
The variance request is for only an age or capacity variance and not both.
A variance cannot be avoided by changing my license class (moving to a C3 is exempt).
I do not have an outstanding correction order.
I do not have an active correction order regarding: supervision, corporal punishment, infant safe sleep or over-capacity.
Neither I nor any household member are currently under investigation by child protection or licensing.
I do not have a pending, existing or appealing a negative licensing action or it has been more than 3 months since my negative licensing action ended.
I will develop alternative measures to help ensure safety of all children.
I have the appropriate equipment to accommodate the numbers of children I will have in care.
I have emergency transportation plans for all children in care.
If I have a child with special needs in care, I have taken measures to ensure their needs are met during the variance period.

Please complete the entire form. If conditions are met you will be directed to the proper paperwork.

Variance requests, along with a completed checklist, need to be submitted to Blue Earth County for review at least 30 days in advance. Blue Earth County will not discuss variance requests until all paperwork has been submitted and reviewed.

To view a pdf of the full Variance Policy and Procedures click here.