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uiiy OT v^rono <br />Variance Application <br />bAHIbll A <br />street Address: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />Application # OS “ <br />Date Received \ <br />Amount Paid <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O, Box 66 <br />Crystal Bay. MN 55323-0066 <br />Staff: _JML(£i <br />Fee: S600 <br />Renewal: $300 <br />After-the-fact: $1,200 Double Fee <br />This application form must be completed in full. App leant will be notified within 15 days as to the status of the <br />application. Incomplete applications wilt not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION^ <br />Site 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 □ Other <br />Zoning District:____________________ <br />APPLICANTJNFORMATION: (Complete legal na.-es and marital status required for each interested party) <br />Name; '• 7C4i^jii07^ <br />Phone (home): <br />Address; <br />Email; <br />^7oPhone (work): iSZ^ <br />'p>fZ4^/^'^MslAKPZ /-fJ <br />Fax: <br />OWNER INFORMATION: (Complete legal names aid marital status required for each interested party) <br />Name: f HkC^P< ft' <br />ne): 47/Phone (home); 4-7/ "/Z^> 7_____Phone (work); <br />Address. <br />Email: -—• Fax; <br />DESCRIPTION OF REQUEST:Estimated Project Cost; $ <br />i^lLM <br />f. r,. - ^ <br />If.' <br />t L i