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muM A <br />City of Orono <br />Variance Appiication <br />Street Addnaa: <br />2750 Kelley Parkway <br />Orono. MN 5S3S6 <br />Application# _ <br />Dale Received. 1'2^'Zd 04f <br />I -1 <br />Main: 952-249-4600 <br />fax: 952-249^16 <br />Mafflng Addreaa: <br />P.O. Box 66 <br />Crystal Bay. MN 55323-0066 <br />Amount Paid: nfPM. <br />Staff: lACi <br />Fee:$600 <br />Renewal: $300 <br />After-the-fact: $1.200 Double Fee <br />This application form must be compieled in full. Applicant will be notified within 15 days as to the status of the <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: Mta -yr. <br />Property Identification Number (PIN): _____________________________ <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): h/n □ Yes, i own the adjacent parcels. <br />Present use of property: O Residential ^ □ Other _______________________ <br />Zoning District: _________________ <br />APPLICANT INFORMATION: (Completo legal names and marital status required for each interested party) <br />Phone (home): ________Phono (work): v.5':2 _ <br />Address: ryr. iSt>_______________City: uUt/TArPt______Zip: <br />Email: . eiMuM . _______Fax: <br />OVVNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: AA-dntp _________ <br />Phone (home): <br />Address: <br />Email: <br />Phone (work): <br />______City: <br />Fax: <br />Zip: <br />OE8CRIPTION OF REQUEST: Estimated Project Cost: $ <br />Describe the request In detaH (attach additional sheets if necessary): ______________________ <br />Avr> pyiPOd "To .-dtTtP= ___________ <br />AX/ .-itjeus*^ A a PT> W AF>r? C?AtJ£TP*