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City of Orono <br />Variance Application <br />EXHIBIT A <br />I 4 : <br />street Address: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />MaHIng Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 553230066 <br />Application# Oft <br />Date Received: <br />Amount Paid; jyo6.^ <br />Staff; _ JHJih ~ <br />Fee:$600 <br />Renewal: $300 <br />After-the-fact $1,200 Double Fee <br />This application form must be completed in full. App icant will be notified within 15 days as to the status of the <br />appiication. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: <br />(PIN):Property Identification Number (PIN): <br />M A ^ ^ SO • A C a« A it ~ _ . _ . W K <br />h/A^iJrA MA/ K'CJO/ <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: Ifrt^esldential □ Other______________________________ <br />Zoning District: Lfi~ //Q________ <br />APPLICANT INFORMATION: (Complete legal nares and marital status required for each interested party) <br />AuAte/9us/^o / _________ <br />Phone (work): ^ <br />Name: MMU 4 m AAA/iA Ao/ <br />Phone (home)r ^ <br />Address: S/i b o <br />9^^ <br /><HojLe /)JPil/c <br />//2 4/ <br />k/^tA?Ar4 ju/u 4Vy^/ <br />F»: .Email: A^APru/JrA, ^ y4rsi . Z’nju - S293 <br />OWNER INFORMATION: (Complete legal names s.nd marital status required for each interested party) <br />Name: MA au f mA p/u /x A u J /'/^o rnAA^A ^ ________ <br />PhonePhDne(work): //2 <br />Address: A'OJtrH f/YOAi^ A Al/'wAfiArA m A' S’^J <br />Fax: VEmail: A^apaz /Jt A ^ AoL.f 7/ - <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ //. <br />Describe the rMuest in detail (attach additional sheets if necessary): K/&. .. <br />//Jyi? >.