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J <br />City of Orono <br />Subdivision Application <br />Stnet Address: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />Main; 652-249-4600 <br />fax; 6S2-240-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />This application form must be completed in full. <br />Application# - <br />Date Received <br />Amount Paid; -3f Tj? <br />Staff ; . \AsiUi' <br />Fee; t-78PVtO <br />Renewal; <br />• f wj U0 * a* (i <br />PROPERTY INFORMATION^. <br />Site Address; ^0 I Te tv<».K/ <br />Property Identification Number (PiN): <br />(Attach iegal description to appiication if not included on the survey.) <br />Date Property Acquired (month^ear): _______□ Abstract or □ Torrens, please check one <br />Present use of property: •G^esidimtial □ Other <br />Zoning District: )<. I O <br />APPLICANT I <br />Name: <br />I^ORMAT <br />1/4/.?' 4/^^' /V 7^(Coo^te lyyljwmes and maritaUtpty requjred^pr each kite[Mt^ <br />Phone (home)______________ <br />Address: I "t <br />t <br />Email: t~V\/xr’<» r <br />i^ir C- I? a . <br />‘■la )e» xft' i» V* 4 . t 6 IVl <br />Phone (work):ZOTB ^ ^4 uJa^ <br />LAJ^t ZS3^ fy\ f“ 5V7 g <br />Fax: <br />OWNER INPQBMATiON: (Complete hraal namu and marital <br />»r L I r. ^ ^ Phc <br />Name: <br />Phone (home): ^12 <br />al namu and marital status required for each interested party) <br />Address;\ *‘\ r lA/^ <br />Phone (work); <br />EmaH;Pax; <br />EXI8TINO LAND USE: <br />Number of Tax Parcels; <br />Development Size: <br />I <br />^ * J <br />Acres Dry Land <br />Acres WSt Land <br />Acres TOTAL, all parcels <br />\ <br />Present Use (check one) <br />Present Zoning District <br />d Residential; Number of Units; <br />□ Other:JSpecify) <br />i. 12. ) B -------------I <br />Proposal: <br />□ Division for Tax Purposes <br />□ Lb K Line Rearrangement Only (no new building sites) <br />^|2^ubdivision for New Building Sites <br />Number of Building Sites / Existing Units <br />J New Units <br />“Z— Total Units <br />Proposed Gross Density 2^ Units per <br />Minimum Lot Size <br />Proposed Use (check) <br />Acres <br />4iay L d Square Feet Dry Buildable Land <br />Residential <br />□ Other (specify) <br />-10-(/r ? <br />*•'4. v -r* •o