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E?<Hie>ir A <br />City of Orono <br />Variance Application <br />Stnet Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249^600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Application # <br />Date Received: <br />Amount Paid: ______. <br />Staff: <br />Fee: _|600 __________ <br />Renewal:$300 <br />Afler-the-tact: $1.200 Double Fee <br />This application form must be compteted in fuB. Applicant wll be notified within 15 days as to the status of the <br />application. Incompitto applicationt will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address:SS3^V <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: ]pif Residential □ Other______________________ <br />Zoning District: _________________ <br />APPLICANT INFORMATION: (Complete leoal naines and marital status required for each interested party) <br />^ P- 6-u<TA r^tJ - atv/^4 Td ____________Name: <br />Phone (home):Phone (work): ______ <br />______City: Zip: <br />Email: T-ePfg Fox: - Yf/- --------- <br />Address: 4^02^9 <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: &TtjfeL jvA* T~o _____^ <br />Phone (home): __________r— <br />Address: _______City:_______________Zip: <br />Email: .^-owy Fax: <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ <br />Descrite the request in detail (attach additional sheets if necessary): _______ ______________ <br />d <br />\p» - ^t *■'i <br />J