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City of Orono <br />Variance Application <br />Street Address; <br />2750 Kelley Parkway Application # Z <br />hL Orono, MN 55356 Date Received: <br />F -Al) 1 -7 <br />Main: 952-249-4600 Staff <br />lax: 1152-241-4616 <br />MalfingAddress. Fee: $700 IP -4 <br />P.O. Box 66 Escrow: <br />HO Crystal Bay, MN 55323-0066 Notes: 05D�K:�' <br />X_ <br />PC Exhibit A <br />Please complete. Applicant will be notified within 15 days as to the status of the application. <br />Incomplete applications will not be placed on Planning Commission Agenda. , <br />SITE LOCATION: <br />rA <br />L <br />Lk <br />DESCRIPTION OF REQUEST: <br />(attach additional sheets as necessary) <br />APPLICANT INFOTMAITION.- 0 c ck h1reJif A�pplri nt addrio-qq nihnidd F <br />in 9 <br />Applicant: <br />Phone (Primary): <br />9 <br />Mailing Address: J-'7 <br />la:S�-E� City: ZIP: -5-53-K <br />-A ;VI � <br />Email: Ve do iA -0 A 1 '0 lt� NAA <br />PROPERTY OWNER INFORMATION: 12( hheck here if Property Owner is same as applicant <br />Name: Vcheck here if Property Owner address should be used for billing <br />Phone (Primary): <br />Mailing Address: Citv- ZIP - <br />Email: FEB 9 9 <br />APPLICANT AND/OR PROPERTY OWNER: <br />CITY OF ORONO <br />Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and property owner <br />recognize that they are solely responsible for submitting a complete application being aware that upon failure to do so, the <br />staff has no alternative but to reject it until it is complete or to recommend the request for denial of the request regardless <br />of its potential merit. <br />The Property Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the <br />property by City Staff, consultants, agents, Commission and Council Members for purposes of investigation and verification <br />of this request. <br />Property Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the Planning <br />Commission and Council. If an applicant and/or property owner is unable to attend a scheduled meeting, please make <br />arrangements to have an authorized representative attend in place of the applicantlowner and advise the City Planner <br />assigned to your project. <br />0 Intormation Will De distr <br />Applicant Signature: <br />Applicant Signature: <br />Property Owner Signaturc <br />Property Owner Signatur( <br />Variance Application — January <br />Date: 1 -7 <br />Date: 17 <br />Date: <br />Date: I Ai(�z-3 -7 <br />r-cruv -'P # 3909 <br />