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City of Orono <br />Variance Application <br />EXHIBIT A <br />Streot Addnas: <br />2750 Kelley Partcway <br />Orono, MN 55356 <br />y' <br />Main: 652-249-4600 <br />fax: eS2-249-46ie <br />Mailing Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 65323-0066 <br />Application# <br />Date Received; ~j O^/ <br />Amount Paid: <br />Staff: <br />Fee: <br />3c;c' <br />Renewal: S300 <br />After-the-fact 11.200 Double Fee <br />This appHcatloit form must be completed In full. AppHcant will be notified within 15 days as <br />application. Incomplete applications wlil not bo piaced on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site ^idress: LH <br />Property IdentificaTfon Number (PIN):rroperly luwiuiiwoviwn ^■»ulllwwl y •!•/. ‘7/^*'m* <br />(Attach legal description to application if not Included on the sunrey.) <br />Date Property Acquired (month/year): |^|0\ n Yes, I own the adjacent parcels. <br />Present use of property: Cjl^Residentiar ‘ □ Other ------------------------------------------- <br />Zoning District; __________ <br />APPLICANT•*** interested party) <br />Phone (home)r <br />Address: //>n<=r ______________ <br />Email: fJby^di P y\iv)r>6i.rrw\ Fax: <br />ORMATION: (Complete legal nsT.es and mari^latal <br />rA^ £^VjeoU f <br />\ ~ Phone (work: <br />a <br />OWNER INFORMATION; (Completo legal names a.-.d marital status required for each Interested party) <br />Name: ^ v ^-------------------------------------------------------------------------- <br />_________________Phone (work): ____________________Phone (home): <br />Address: ___ <br />Email:Fax: <br />DESCRIPTION OF REQUEST; Estimated Project Cost $ ^^QJQ <br />Describe the request In detail (attach ad^rtional sheets If necessary):________________________ <br />________i iAavA^vM_______________• ___________________________ <br />i <br />m <br />1 <br />->