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City of Orono <br />Variance Application <br />street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main; g52-246-4600 <br />fax: 652-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Application# <br />Date Received; <br />Amount Paid: if <br />Staff: JkhllJS <br />Fee:$600 <br />Renewal: $300 <br />After-the-fact $1,200 Double Fee <br />This application form must be completed In full. Applicant will be notified within 15 days as to the status of the <br />application. Incomplete appHcations will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: <br />Property Identification Number (PIN): =$ Z.33Z.0663 <br />(Attach legal description to application if ncn included on the survey.) <br />Date Property Acquired (month/year): □ Yes. I own the adjacent parcels. <br />Present use of property: M Residential □ Other <br />___LR'16Zoning District: <br />APPLICANT INFORMATICpN: (Complete legal names and marftai status required for each :,iterested party) <br />Name: moQ k ___________ <br />Phone (home): 95^. _______Phone (work): 2o'?3 <br />Address: tlCZa Uury^ ________City: ________Zip: <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: _______________________ <br />Phone (home): ______ <br />Address: —. <br />Email: \aS!»52sste Zip: <br />DESCRIPTION OF REQUEST: Estimated Project Cost: <br />Describe the request In detail (attach additional sheets If necessary): __________ <br />yarA vcrfK«*v\cg S~L____________________________ <br />f| <br />Ji <br />erf