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City of Orono <br />Variance Application <br />EXHIBIT A <br />Stf99t AddfBSs: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />m Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Addnss: . <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Application # \ <br />Date Received: \2.-So -O <br />Amount Paid;^ u? OO. o c? <br />Staff: JiB <br />Fee: S600 <br />Renewal: S300 <br />After-the-fact $1,200 Double Fee <br />This application term must be completed in full. 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 INFORB^TIDN:./ K <br />Site Address: <br />Property Identification Number (PIN): <br />(Attach legal description to application if i^ncluded on the survey.) <br />Date Property Acquired (n^h/year): ly fi/h □ Yes, I own the adjacent parcels. <br />Present use of propgi^: b other <br />Zoning District:A <br />APPLICANT INFORMATION: (Complete legal narres and marital status rMuired for each interested party) <br />Name: rXPCT) ________________/% / <br />Phone (home): 4^7:5- '^OJ^ Phone (woik)/ 12-10 ^2JL)U^ <br />Address: KJof7)^ ^/yrrii. ^ <br />Email:Fax: ^ <br />Phone (home): <br />Address: <br />Email: <br />FORMATION: (Complete legOWNER INFORMATION: (Coiyplete legal names ar.d marital status required for each interested party) <br />Name: <br />Phone (work): <br />Fax: <br />DESCRIPTION OF REQUEST:Estimated Project Cost: $ <br />D^ribe the request in detail (attach ^^iongl sh^ts if necessary): ^ ^ ^__ <br />f Ijn I <br />ik