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oiiy OT urono m ^ <br />Variance Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />•if I' <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 />Application# C‘) <br />Date Received: <br />Amount Paid: ( oCpCDt oo <br />Staff: kAeXri Zi7. <br />Fee: S600 <br />Renewal: $300 <br />After-the-fact: $1,200 Double Fee <br />This application form must be completed in full. Appleant will be notified within 15 days as to the status of the <br />epplicatian. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPB^TY INFORMATION: . <br />Site Address: 6aUiir P<X <br />Property Identification Number (PIN); lot 7 , /d . e <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): h/9^ □ Yes, I own the adjacent parcels. <br />Present use of property: [^Residential □ Other_________________________ <br />Zoning District: __________________ <br />APPLICANT INFORMATION: (Complete legal nar:6s and marital status required for each interested party) <br />Name; r/$r^i /Me Do <br />Phone (home)i - v 7/- <br />Address: /</;>.o pk <br />Email: go/- C«'*v-V <br />__Phone (work): o<9oy <br />(/:'n: ''.-t 5 >^7/_________________ <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: $ S.ooo • fo o <br />Describe the request in detail (attach additional sheets If necessary): ____________ <br />______oX CDvcr/c/ DorCflt on -sy S/Je nX Pr/m. . atdx- <br />de-'/a{/s'^ <br />L <br />.: ,x T <br />O i O'-- -4 - -