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V <br />City of Orono ^. A <br />Variance Application_____ <br />Street Addresr,: <br />2/00 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P O. Box 66 <br />Crystal Bay. MN 55322-0066 <br />Application # ^ <br />Dale Received. <br />Amount Paid [pCi]- 4) <br />Staff: lUr-icuh-k <br />Fee S600 <br />Renewal $300 <br />After-the-fact $1,200 Double Fee <br />This applicalion form must be completed in full. Appicant will be notified within 15 days as to the status of the <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />C~ ^ ft fvv A IvJ PSite Address: _____ <br />Property Identification Number (PIN); _____________________________________________ <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): □ Yes, I own the adjacent parcels. <br />Present use of property; ^ Residential □ Oiher __________________________________ <br />Zoning District:____________________ <br />APPLICANT INFORMATION: (Complete legal ns-as an ‘ marital status required for each interested party) <br />Name: O m f\ Y. k i to .T r H f- c (O________________________ <br />Phone (home); ____ <br />Address: lo c ft P, fA ^ <br />Phone (work): .V\^h <br />Email; \ V Fax: <br />OWNER INFORMATION: (Complete legal names a'd marital status required for eacn interested paity) <br />Name:_________________________________________________________________ <br />Phone (home);________________________ <br />Address; _____________________________ <br />Email: <br />Phone (work); <br />Fax: <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ <br />Describe the request in detail (attach additional sneets if necessa ''):_______________ <br />__•< lC>r»t:tO(\ rVoc*\>, » <br />r c<*>. Aj.'VS. '.•„■<i-^.N . •» <br />...^ t\fjCA-v.V^\ i-A J ■ ' utrr V ir <br />g/ (T'% 0"\ <br />”4' <br />1/1 4; u-