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City of Orono Amendment Application ❑ Comprehensive Plan / $ Ordinance Text / ❑ Zoning Change (check one) street address: 2750 Kelley Parkway Orono, MN 55356 Main: 952-249-4600 fax: 952-249-4616 Mailing Address: P.O. Box 66 Crystal Bay, MN 55323-0066 Application ail , Date Received Staff Fee $700 Escrow $700 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 Wayzata Blvd., Orono, MN 55356 APPLICANT INFORMATION: )(check here if Applicant address should be used for billing Applicant: Dale Richardson Phone (Primary): Mailing Address: P.O. Box 575 City: Lono Lake ZIP: 55356 Email: Commercial Buildin Sery live.com PROPERTY OWNER INFORMATION: ❑ check here if Property Owner is same as applicant 13check here if Property Owner address should be used for billing Name: BS - P � s Phone (Primary): 612-708-6085 Mailing Address: P.O. Box 575 _ City: Long Lake ZIP: MN Email: CommercialBuildin Sery live.com APPLICANT AND/OR PROPERTY OWNER: PC Exhibit A 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. w Property Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the Planning Commission and Council. If an applicant andlor 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 distrit Applicant Signature: Applicant Signature: Property Owner Signature: Property Owner Signature: Amendment Application - January 2017 Page 4 Date: Date: Date: Z2 Date: RECEIVED JAN 1 7 2017 3898 CITY OF ORONO