Laserfiche WebLink
tAiTibn <br />street Addmss: <br />2750 Kelley Parkway <br />Orono. MN 5S3S6 <br />Main: 952-2404600 <br />fax: 952-2404616 <br />MaUng Address: . <br />P.O. Box 66 <br />Crystal Bay. MN 55323-0066 <br />Application# <br />Date Received: ^iZ^JOfr <br />Amount Paid: Jbob- <br />Staff: <br />Fee: S600 <br />Renewal: $300 <br />After-the-fect: $1.200 Double Fee <br />This applicalion form must be completed in full. App scant 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 />Site Address: <br />Property identifica^ Number (PIN): <D^ I / "7.^ 331OC H n <br />(Attach legal description to application if included on <br />Date Property Acquired (montIVyear): IfmCSra Ye <br />Present use of prope^: pf Residential D Other__ <br />Zoning District: KIZ>^ I & <br />iecluded on the survey.) <br />Yes, I own the adjacent parcels. <br />APPLICANT INFORMATION: (CompMs legal nar es and marital status required tor each interested party) <br />Name. AtCt»gcc€^ ___ ______ <br />Phone (home). _________Phone (work): ---------- <br />Address: /^73i P/tc^on^ — <br />Email: ^ Wf ULboo a g "7 ^ — <br />OWNER INFORMATION: (Complete ImsI names and marital status required for each interested rarty) . <br />Marne' rVtlTTftg*^ (rv^rT/ln^g3^ rAlcH^ccg L/^An.(iiBO_Y <br />Phonefh^^: - Phone(work): Ul^-gT? <br />Address:_______ t<r^72. pt^*^0(Ur CMC- Alt/g/t. >vi<^ — <br />Email: €)Fax: ?*/. <br />DESCRIPTION OF REQUEST: EstimatedPioject Cost: <br />Describe the request In detailiattach additional sheets if necessary): Jpe>rvi4> o A- e>ii".sf»Vi^^ > <br />---------------------------------------------------------------------------------------------------------------------- <br />. .*• ■ -x fi: <br />r; - )■ '