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EXHIBITACity of Orono <br />Variance Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 5532S^066 <br />Application # ^ <br />Date Received: <br />Amount Paid: <br />Staff: JAN/Ce <br />Fee:S600 <br />Renewal: S300 <br />After-the-fact: $1,200 Double Fee <br />This application form must be completed in full. Applicant 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 INFORMATION: <br />Site Address: *7 H o KJ a r •^U ^ f <br />Property Identification Number (PIN): <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): □ Yes, I own the adjacent parcels. <br />Present use of property: lij Residential □ Other •_________________________ <br />Zoning District: ___________________ <br />APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br />anie: fl-^ L a-voV <br />r»hone (home): C(*\^ *=1t»a _______ <br />Address: 8(!> S'R C^C'etu V A-tcoug. <br />Email: _____________ <br />. Phone (work): (g s-a.'^ *=\o{p - <br />Pra.if-1^ rv\ tsj g ’S'aK? <br />Fax; rciia.'^ RO(g - m <\_______ <br />OWNER INFORMATION: (Complete legal names sr.d marital status required for each interested party) <br />Name: ________ ^cx-wia,.. ols ou U ou ^__________________________________________ <br />Phone (home): _______________________ <br />Address: ____________________________ <br />Email: ______________________ <br />Phone (work): <br />Fax: <br />DESCRIPTION OF REQUEST: Estimated Project Cost: <br />Describe the request in detail (attach additional sheets if necessary): ___________ <br /><xll Qt.,jT <br />ry w 5^\A-u q <br />Wo V\Vo L y\ <br />rv • <br />k <br />j^hJL '4 Iill4 JLS <br />t <br />uiiiMjia