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I City of Orono BjWUTA <br />Variance Application '/V <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />V T-.' <br />Main: 952-249-4600 <br />fax: 652-249>4616 <br />Melting Address. . <br />P.O. fox 66 <br />Crystal Bay, MN 55322-0066 <br />Application# ^^3^35 <br />Date Received:Yif^nss <br />Amount Paid: /. . <br />staff: <br />Fee:$600 <br />Renewal: $300 <br />After-the-fect: $1,200 Double Fee <br />This application form must be completed in foil. Applcant 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: ,y . <br />Site Address: /Jr^rHr bkPre <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: l^iCesidential □ Other _______________________ <br />Zoning District: _________________ <br />APPLICANT INFORM/^TION: (Complete legal nares and marital status required for each interested party) <br />Name: AJus <br />Phone (home): W 7/-Q Phone (work): (95^ )H~7Z'5 ! oy' <br />Address: 3*-/g^tP s\no^c, hnoe. MtO <br />' - • - Fax: ‘ 'Email: aoI <br />OWNER INFORMATION: (Complete legal names and marital status required for each Interested party) <br />Name: ___________________ <br />Phone (home): <br />Address: __ <br />Email: <br />Phone (work): <br />Fax; <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ <br />Describe the request in detail (attach additional sheets if necessary): ______________ <br />r.vM6 6 <br />i»C <br />4 \I i