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City of Orono <br />Variance Application <br />StreetAddress: <br />2750 Kelley Parkway <br />Application # <br />Orono, MN 55356 <br />Date Received: R <br />Main: 952-249-4600 <br />Staff ; <br />fax 952-249-4616 <br />Mailing Address. <br />Fee: $275 <br />P.O. Box 66 <br />Escrow: <br />Crystal Bay. MN 55323-0066 <br />Notes: <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:t-- <br />DESCRIPTION OF REQUEST: <br />(attach <br />necessary) <br />APPLICANT INFORM ff N: Wt check here if Applicant address should be used for billing <br />Applicant: -11 <br />Phone (Primary): cZ <br />Mailing Address: 2-0 I _ STQ C. <br />ZIP: <br />Email: � � � � � - � - <br />Tio <br />PROPERTY OWNER INFORMATION: 0 check here if Property Owner is same as applicant <br />13 check here if Property Owner address should be used for billing <br />Mame: raQ �� pre I IQ <br />Phone (Primary): <br />Mailing Address:I On <br />, C' ZIP. <br />Email: hl�b <br />APPLICANT AND/OR PROPERTY OWNER: <br />• Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and praperty 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 acknawtedge 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 applicantiowner and advise the City Planner <br />assigned to your project <br />• Information will be distributed -a ail. <br />Applicant Signature: 4N)— <br />Date: <br />1 <br />Applicant Signature: Date: <br />Property Owner Signature: <br />Property Owner Signature: <br />Variance Apprica5on – September 2017 <br />Page 4 <br />Date: 1 Z 13 REQ , <br />Date: <br />0 0 Ci -Y OF ORONO <br />