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City of Orono <br />Variance Application <br />street Address: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />Application # 0 V" Z- <br />Date Received; <br />Main: S 52-249-4600 <br />fax; 952-249-4616 <br />Mailirtg Address: . <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Amount Paid: SfLof) * <br />Staff : <br />Fee; S600 <br />Renewal: S3O0 <br />Atter-the-fact: $1,200 Double Fee <br />This application form must be completed in full. Appiicant will be noticed withm 15 days as to the status of the <br />appiicstion. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address:dy.Aj}CiD(i }2.cL <br />Property Identification Number (PIN): I 1 I “Tz, WOO Q___________ <br />(Attach legal description to application if not included on the survey.) ^ <br />Date Property Acquired (month/year): '7- o <\ □ Yes, 1 own the adjacent parcels. <br />Present use of property: □ Residential ^ □ 0*Jier ____________________________ <br />Zoning District: _____________________ <br />APPLICANT INFORMATION: (Complete legal na.~es and marital s/.atus required for each interested party) <br />Name:CKri*i>’K<ve. VcLi-^/gL^*^S <br />Phone (home): Unt- I T Phone (work); <br />Address: ' /Ld _____________ <br />Email: ____rv\g\*> ^ r rO Fax; <br />0^)11-^- •2^72--(-)“)■*- <br />CcVv-i <br />OWNER INFORMATION: (Complete legal na.Ties e.'d marital status required for each interested party) <br />Name: ___________ <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): ______________