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City of Orono <br />Subdivision Application <br />^reet Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Application# O 5 <br />Date Received: -X<- 2.cg3S <br />Renewal: <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />This application form must be compieted in full. <br />Amount Paid: <br />Staff: _____________ <br />Fee:r.^oo - oo <br />PROPERTY INFORMATION: ^ y. <br />Site Address: %> -VtC GxiT <br />Property Identification Number (PIN): ^2 ad'7 ^ ^ X3 Oo‘y^ <br />.(Attach legal description to appiication if not included o^e survey.) <br />Date Property Acquired (month/year): AU g J^CAbstract or □ Torrens, please check one <br />Present use of orooertv: □ Residential * b Other TzifJ /74» ______________ <br />Zonlno District: rL S <br />^APPLICANT INFORMATION: (Complete legal names an <br />Name: C Sd’d* <br />d marital status required for each interested party) <br />Phone (home):Phone (work): <br />Address: <br />Email:Fax: <br />' OWNER INFORMATION: (Complete legal names and rm <br />Name: (’Sff <br />irital status required for each interested party) <br />Phone (home):Phone (work): <br />Address: <br />Email:Fax: <br />EXISTING LAND USE: <br />Number of Tax Parols: <br />Development Size:Acres Dry Land <br />Acres Wet Land <br />Acres TOTAL, all parcels <br />Present Use (check one) <br />Present Zoning District <br />H Residentiai; Number of Units: <br />Other (Specify) <br />-JkA________ <br />Proposal: <br />□ Division for Tax Purposes <br />0 Lot Line Rearrangement Only (no new building sites) <br />□ Subdivision for New Building Sites <br />Number of Building Sites ______ <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check) <br />Existing Units <br />New Units <br />Total Units <br />Units per Acres <br />Square Feet Dry Buildable Land <br />L <br />□ Residential <br />□ Other (specify) <br />-10-Jil€7^ <br />U <br />\ ^ <br />\ •: <br />V-:*/ <br />j- <br />i