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City of Orono <br />Variance Application <br />Stnot Address: <br />2750 Keney Parkway <br />Orono, MN 55356 <br />Main; 952-249-4600 <br />fax; 952-249-4616 <br />Matktg Address: . <br />P.O. 66 <br />Crystal Bay. MN 55322-0066 <br />Application # <br />Date Received; <br />Amount Paid; <br />Staff; JNi/, <br />Fee; $600 <br />Renewal; $300 <br />After-the-fact $1,200 Double Fee <br />» ? <br />This applicaiion form must be completed in foil. Applcant wilt be notified within 15 days as to the status of the <br />application. Incomplete appileations will not be placed on Planning Commlseion 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: □ Residential /at)ther _________ <br />Zoning District: __________________ <br />APPLICANT INFORMATION: (Corriptete legal naras and marital status required for each interested party) <br />Name: ______________________________________ <br />Phone (home): aiyiQ Phone (work): <br />Address: itA. ______!---------------------------------------^------ <br />Email: /inoiMQ ____________Fax: An\-ii^An^ <br />OWNER INFORMATION: (Complete legal names a.*id 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 />i i I i i -i <br />_____________^ <br />/ /Ilf --.j’ <br />I