02-13-2017 Council Packet - Laserfiche WebLink

Home Browse Search

City of Orono Variance Application Street Address: P2750 Kelley Parkway Vn Orono, MN 55355 Main: 952-249-4600 fax: 952-249-4616 Mailing Address.- P.O. ddress.P.Q. Box 66 Crystal Bay, MN 55323-0066 Application # Ko - a5 fl s Date Reoeived: _ q -L. - I b Staff : CM Fee: 1700 Escrow # & $ 1150b Permit Fee Notes: PC Exhibit A Please complete. Applicant will he notified within 15 days as to the status of the application. Incomplete applications will not be placed on Planning Commission Agenda. SITE LOCATION: DESCRPTION OF REQUEST: APPLICANT / Al Applicant Name: Phone (Primary): Applicant Email: Address: Applicant is: cc PROPERTY OWNER INFORI Name: Phone (Primary): != Mailing Address: ( d Email: G h I c (attached additional sheets as necessary) Homeowner (Circle One) Q check here if property gwner is same-,ps,applicant ZIP: 5 ZIP: APPLICANT/AGENT AND/OR OWNER: • Agree to provide all information required or requested by the Planning Department, • Agree to pay additional fees (staff time not covered in the original fee payment) and/or consultant expenses incurred in review of this application, and • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and owner recognize that they are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to reject it until it is complete or to recommend the request for denial of the request regardless of its potential merit. • Acknowledge the Escrow Agreement is completed and signed. • The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property by City Staff, consultants, agents, Commission and Council Members for purposes of investigation and verification of this request. * Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the Planning Commission and Council. If an applicant and/or owner is unable to attend a scheduled meeting, please make arrangements to have an authorized representative att d in place of the applicant/owner and advise the City Planner assigned to your project. II Applicant/Agent Signature:) Date: ILA Applicant/Agent Signature: Date: Property Owner Signature: Date: �© Property Owner Signature: iiA Date: G 'do 64EIVED Variance Application — May 2046 page 2 SEP 21 2016 3 CITY OF ORONO