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City of Orono <br />Variance Application <br />Street Addnss: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Application# 09-3)37 <br />UlMlir: <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />MaUIr^ Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Date Received: la - tZ -oC <br />Amount Paid: i aOO> oo <br />Staff: <br />Fee: $600 <br />Renewal: $300 <br />After-the-fact: $1,200 Double Fee <br />This application form must be completed in full. Applcant will be notified within 15 days as to the status of the <br />application. Incomplete applications wiil not be piaced on Pianning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address; <br />Property Identification Number (PIN): 1/7- 3f -OO'fC. <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (m^h/year): 'shs 0^Yes, I own the adjacent parcels. <br />Present use of property; ET Residential □ Other <br />Zoning District; - / /5 ’ <br />APPLICANT INFORMATION: (Completa legal nares and marital status required for each interested party) <br />Nani®: KoftfcA-T ^ - - <br />Phone (home); ________Phone (work): </ 75-- 24^7 9 <br />•S'io T" .Address <br />Email:Fax: <=isZ ’- ) <br />OWNER INTORMATION: (Complete legal names a.-id 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: $ S^iOe:^ <br />D^cribe the request in detail (attach additional sheets If necessary); <br />—^4olu-.g :Sc>* *0 <br />U Cst /LerK ' * <br />(5 <br />ajxii*d^nni