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City of Orono <br />Variance Application <br />■*C*. * <br />street Address: <br />2750 Kelley Parlo*»ay <br />Orono, MN 55356 <br />r Main: 952-249^00 <br />fax: 952-249-4616 <br />Maying Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 55323^)066 <br />Application# O‘5-'b0^ \ <br />Date Received: ^ hnioK <br />Amount Paid:, (anC\ (rO <br />Staff: KAlX^Xjnic, CurM'i <br />Fee: S600 <br />, Renewal: $300 <br />After-the-fact ^200 Double Fee <br />This application form must be completed In full. Appleant 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: S<r^ ^ <br />Property Identification Number (PIN): <br />(Attach legal description to application if included on the survey.) <br />Date Property Acquired (m^th/year): Lo/*t □ Yes. I own the adjacent parcels. <br />Present use of property: Residential'^ u Other ___ <br />Zoning District: <br />APPLICANT INFORMATION: (Cmplete Ittgai narres and marital status required for each Interested par^} <br />Name: 'jU _______________________________________ <br />Phone (home): <br />Address: <br />Phone ^-gyve/ <br />Email:¥LI<ki Fax: <br />OWNER INFORMATION: (Complete legal names and 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 />ATUjU gJuLy ct ^ <br />\ -* <br />^Sr • ^h- <br />' vX <br />r^‘ S'] <br />I / /:‘ftr s/*i r <br />U <br />iv <br />- / <br />j