07-11-2005 Council Packet - Laserfiche WebLink

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City of Orono Subdivision Appiication EXHIBIT A street Address: 2750 Kelley Parkway Orono. MN 55356 Amount Paid: _z W- Ul'Ml1 i Fee: Renewal: Main: 952-249-4600 fax: 952-249-4616 Mailing Address: P.O. Box 66 Crystal Bay, MN 55323-0066 This application form must be completed in full. PROPERTY INFORMATION: Site Address: /7YJ ’ rrjiffr Property Identification Number (PIN): - Htt -aooi /j /a^/n-Z3-//~ae>o/ (Attach legal description to application if not included on the survey.) Date Property Acquired (month/year): _______Hi. Abstract or □ Torrens, please check one Present use of property: ^Residential □ Other ________________________________ Zoning District: ____________________ APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) ^ Name: Phone (home): Koi -opoo Address: ■s.-r:e€€=r Email: Phone (work): fn^ 2.4 c~ M.AJ <r:S~3^ ( Fax: OWNER INFORMATION: (Complete legal names and marital status required for each interested party) Name: Phone (home): Address: __ Email: Phone (work): Fax: EXISTING LAND USE: Number of Tax Parcels: Development Size;2/. // Acres Dry Land s Acres Wet Land r?. Acres TOTAL, all parcels Present Use (check one) Present Zoning District "XL Residential: Number of Units: ^ □ Other. (Specify) __________ _______________ Proposal: □ Division for Tax Purposes □ Lot Line Rearrangement Only (no new building sites) "jBC Subdivision for New Building Sites Number of Building Sites I- Proposed Gross Density Minimum Lot Size Proposed Use (check) Existing Units New Units Total Units Units per .T7.9/ Acres Square Feet Dry Buildabie Land .SC Residential □ Other (specify) -10- . iL (> ■■ I f - •' * i V '............. /! ^ '