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1 <br />m <br />City ofOrono <br />Subdivision Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Kfs;m 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 completed in full. <br />Applicauon # <br />Date Received: a -n.on <br />Amount Paid: x ~?rV. <br />Staff : U: \rc.v./. <br />Fee: ______________ <br />Renewal; <br />PROPERTY INFORMATION: <br />Site Address: I\Co jr~c» ^ r v%e, <br />Property Identification Number (PIN): ~ 11 <br />(Attach legal description to application if not included on the survey.) . <br />Date Property Acquired (month/year): ^/r93A □ Abstract or h Torrens, please check one <br />Present use of property: .fifl Residential □ Other__________________________ <br />Zoning District:<vR-\ A <br />APPLICAI^ INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: G\r\yis4^oV\g.ir H>>rg3\A T^'<&seY\__________ <br />Phone (home): 7^3 - Phone fworkV ^ ~ <br />Address: MOo vv>e. i-A rv\j^pt«» V>\a\v\___________________________ <br />'^.mall: _________________ Fax: <br />OWNER INFORMATION: (Complete legal names and marital status required for each Interested party) <br />Name: />A x r-VVv» g.v\_____________ <br />Phono (home): *4 7<» .JLI’^q <br />Address: JjL^22_j4ic£i^tii)^Ai2oLS__JC.iL <br />Phone (work): <br />Email:Fax: <br />EXISTING LAND USE: <br />Number of Tax Parcels: <br />Development Size:IA.9 I Acres Dry Land <br />Acres Wet Land <br />13 ^ '7*^ Acres TOTAL, ail parcels <br />Present Use (check one) <br />Present Zoning District <br />Residential; Number of Units: {j^ <br />□ Other (Specify) <br />Proposal: <br />□ Division for Tax Purposes <br />□ Lot Une Rearrangement Only (no new building sites) <br />a Subdivision for New Building Sites <br />Number of Buildirig Sites / <br />I <br />Proposed Gross Density <br />tinimum Lot Size <br />Proposed Use (check) <br />I <br />B ' RetieResidential <br />□ Other (specify) <br />.10- <br />Existing Units <br />New Units <br />Total Units <br />Units per 0*^ Acres <br />Square Feet Dry Bulldable Land <br />QQ <br />iiiUrtrfniiatfiiiiitiii