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f! ' <br />K . t <br />City of Orono <br />Variance Application <br />EXHIBIT A <br />O' <br />street Address: <br />2750 Kelley Parkway <br />Orono, MN 5S3S6 <br />rilf Main; 952-249-4600 <br />fax: 952-249-4616 <br />Meilir^ Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Application # <br />Date Received: <br />Amount Paid: SbOn. <br />Staff: ^ImCP <br />Fee;$600 <br />Renewal: $300 <br />After-the-fact: $1,200 Double Fee <br />This application form must be completed in foil. App leant will be notified within 15 days as to the status of the <br />application. Incomplete applicationa will 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: .^TKesidentiaK □ Other_______________________ <br />Zoning District: _________________ <br />APPLICANT INFORMATION: (Complete legal nares and marital status required for e^h interested party) <br />Name: ^ <br />Phone (home): #’^hone (work): — <br />Address <br />Email: <br />frf7 <br />Fax: <br />OWNER INFORMATION: (Complete legal names a.-^d marital status required for each interested party) <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 sheets if necessary): ______________ <br />1 U * m <br />e • <br />V <br />“ffijl