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City of Orono <br />Subdivision Application <br />EXMBIT A <br />Stmet Addnas: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Wl <br />Mi Renewal: <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Addraas: <br />P.O, Box 66 <br />Crystal Bay, MN 55323-0066 <br />This application form must be completed in full <br />Application # ^3 " <br />Date Received: <br />Amount Paid: <br />Staff: . lAtJUlr <br />Fee: _____ <br />PROPERTY INFORMATION: <br />Site Address: /7Y-f XTAtrr <br />Property Identification Number (PIN): /j /a-// <br />(Attach legal description to appiication if not included on the survey.) <br />Date Property Acquired (month/year): _______Abstract or □ Torrens, please check one <br />Present use of property: ^Residential □ Other _______________________________________ <br />Zoning District: ___________________i <br />X APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: yv <br />Phone (work); foPhone (home): c,i^^ %.ot -oeoo <br />Address: M.AJ _s~s"'S°t ( <br />Email: ________________________Fax: _________ <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: *F ______________________ <br />Phone (home);Phone (work): <br />Address: <br />Email:Fax; <br />EXISTING LAND USE: <br />Number of Tax Parcels: <br />Development Size:2/.// <br />1£^ <br />Acres Dry Land <br />Acres Wet Land <br />/•T. /P/ Aaes TOTAL, all parcels <br />Present Use (check one) <br />Present Zoning District <br />Residential; Number of Units: ^ <br />□ Other (Specify) __________ <br />A/i-JA ________ <br />Proposal: <br />□ Division for Tax Purposes <br />□ Lot Line Rearrangement Only (no new building sites) <br />Subdivision for New Building Sites <br />Number of Building Sites <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check) <br />Existing Units <br />New Units <br />Total Units <br />Units per S‘7^9f Acres <br />^7. jia Square Feet Dry Buiidable Land <br />JBC Residential <br />□ Other (specify) <br />•/ <br />a P rl.4 <br />IS--'