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w <br />City of orono <br />Variance Application <br />GCH.h-i <br />^ntAddnu:AoeKcation# <br />2750 Kelley Parkway Date Received: / d H <br />Orono. MN 55356 Amount Paid; c^d>h . o o <br />Staff: <br />Mein: 952*249^600 pee: S600 <br />tec 952-249-4616 Renewat S300 <br />MtKng Addr$9*: <br />P.O. Box 66 <br />ARcr*ma*fsec 11.200 Double Fte <br />Crystal Bay. MN 553230066 • <br />This appBcation fbnn must b« compMad in full. AppTeant v«11l be notified within IS days as to tne status of the <br />appiieatien. Incomplete applieatlone will not be placed on Planning Commission Agendas. <br />PROPeWY INFOl^TjON: <br />SiteAddreas: K cm > N cctu ________________________________ <br />Property Identification Number (PIN): __________________________________ <br />(Attach legal description to application if not included on the sunrey.) <br />Date Property Acquired (month/year): ______□ Yes, I own the adjacent parcels. <br />Present use of proparty: d Residential □ Other <br />Zoning District: '<> <br />APPLICANT INFORMATION: (Complete legel neree and marital status required for oach irfterested party) <br />Name: "Tesi fiuU/iuLt <br />i: W‘5*52.^ 4-H.- aA-^OPhone (home): <br />Address: Ftf-eNOi»up. gca»-o r\iog-TH <br />Phone (work): ^C4- - <br />Email: MKicuii itAiM Fax: <br />OWNER INFORMATION: (Complete legtl names s.*d marital status required (or each interested patty) <br />Name: <br />Phone (honte): Phone (work): <br />AddroM: ___________________________________________________________ <br />Email; ____________________________Fax: <br />DESCRIPTION OF REQUEST: Estimated Project Cost S 20i00o <br />Describe the request In detail (attach additional sheets if necessary): <br />VAieTLA-MD pp?rr;»AA^£»id j S>£g ATT/vc.Hgfs T>e^.cnPTtr?nJ