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City of Orono Conditional Use Permit Application StreetAddress: Application # c 2750 Kelley Parkway ! i —,5 5 , Orono, MN 55356 Date Received: 1717-1 Main: 952-249-4600 Staff fax: 952-249-4616 Fee: MailingAddmss: P.O. Box 66 Escrow: $700 / NA Crystal Bay, MN 55323-0066 Notes: Please complete. Applicant will be notified within 15 days as to the status of the application. Incomplete applications will not be placed on Planning Commission Agendas. SITE LOCATION: 2060 W. Wayzata Blvd, Orono, MN 55356 DESCRIPTION OF REQUEST: Conditional Use Permit I DAYCARE (attached additional sheets at necessary) APPLICANT INFORMATION: 0 check here if Applicant address should be used for billing Applicant: Little Acoms / Attn: James Smale Phone (Primary): 612-846-3360 / 763-445-9404 Mailing Address: 1865 W Wayzata Blvd Suite #112 City: Long Lake ZIP:55356 Email: james smale@redpathcg.com PROPERTY OWNER INFORMATION: 17 check here if Property Owner is same as applicant 0 check here if Property Owner address should be used for billing Name: Phone (Primary): Mailing Address: Email: Dale Richardson 612-708-6085 APPLICANT AND/OR PROPERTY OWNER: Lake PC ExhibitA • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and property 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. • The Property 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. • Property 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 property owner is unable to attend a scheduled meeting, please make arrangements to have an authorized representative attend in place of the applicantlowner and advise the City Planner assigned to your project. • Information will be distributed via email. Applicant Signature: Applicant Signature: Property Owner Signature: Property Owner Signature: CUP Application — January 2017 Page 4 Date: Date: Date: Date: RECEIVED JAN 1 72017 # 8 9^ CITY OF ORONO