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C it of O ro n o ����-�-� <br /> Y � <br /> Subdivision Application <br /> Street Address: Application # �� ��_-.�']��,�� <br /> � Q� 2750 Kelley Parkway Date Received: J� ~?.- C��S <br /> Orono, MN 55356 Amount Paid: �j(���`''-= <br /> 0 ,�;� � Staff : •. ' <br /> p��"�������� Main: 952-249-4600 �� <br /> ��r�'�`:,< � Fee: �:�� � <br /> � �i�'�f��'��, � fax: 952-249-4616 Renewal: <br /> �� �.�� , � �ti Mailing Address: <br /> �.�k�������� P.O. Box 66 <br /> Esx� Crystal Bay, MN 55323-0066 <br /> This application form must be completed in full. <br /> PROPERTY INFORMATION: <br /> Site Address: 3��%� ,�' �� ��cP�J ��'1vY'��i�i�� /J�', ����7 �����i c /4 �'c� , <br /> Property Identification Number (PIN): /�-//7-a3 y3 DU �i4� , /7-//7-d.3 y3 OCJ 9.�� l7�/l7-�3 y���c�l <br /> (Attach legal description to application if not included on the survey.) /7-/l�a3 �f 3 OO�P % <br /> Date Property Acquired (month/year): /- /%��� �,Abstract or ❑ Torrens, please check one <br /> Present use of property: ,�Residential ❑ Other <br /> Zoning District: _ �� / � <br /> APPLICAfVT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: �� /� �'� � <br /> Phone (home): 9So2 - y�3` /6':�-0 Phone (work): 9S� — ��3 �- S�_SO <br /> Address: �S-� _Q ���,,,,-f a s /'-�, �C����� (�) �-i Za�f- /1�r� �S3 9/ <br /> Email: Fax: <br /> OWNEE� {NFORN�ATION: (Complete legal names and marital status required for each interested party) <br /> Name: �C-y/� � �J c� �i�� �,5� d � <br /> Phone (home): _ �,s a- y�3 - �J��v Phone (work): _gs� _ �/-73 --S.�s�7 <br /> Address: _ ,_,-:?S U� � '��7�s ✓-��. ��� �e_ �rl���,� ��f�� /Ylr�, ��53 �/ <br /> Email: Fax: <br /> EXISTING LAND USE: <br /> Number of Tax Parcels: ;;�'=. <br /> Development Size: Acres Dry Land ` <br /> Acres Wet Land <br /> Acres TOTAL, all parcels <br /> Present Use (check one) ..�� Residential; i�umber of Units: � <br /> ❑ Other: (Specify) <br /> Present Zoning District _�.,� � J C <br /> ��o�osal: <br /> ❑ Division fior Tax Purposes <br /> ❑ Lot Line Rearrangemenf Only (no new building sites) <br /> ❑ Subdivision for New Building Sites ! °� <br /> � :� <br /> Number of Building Sites Existing Units -- �- <br /> I�ew Unifs c:::>.E: <br /> Total Units ��i �;. � . <br /> Proposed Gross Density Units per Aa-es �r t;y� <br /> Minimum Lot Size Square Feet Dry Buildable Land <br /> Proposed Use (check) ❑ Residential � / <br /> �� Other (specify) � r�a�,� � L� e s 5 ,�c� e_i�� =�7�� <br /> - 10 - <br />