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City of Orono <br />Subdivision Application <br />EXHIBIT A <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 55323-0066 <br />This application form must be completed in full. <br />Application # 0 <br />Date Received: ?t ~X <br />Amount Paid: P.-u . <br />Staff : -Tj. r. I .-,1^ _______ <br />Fee: <br />Renewal: 'v.-'f <br />PROPERTY INFORMATION: - J <br />Site Address: _______3'7-S'O io>'- sJrr._______c <br />Property Identification Number (PIN); _______________________________________________ <br />(Attach legal description to application if not included on the sun/ey.) <br />Date Property Acquired (month/year); ________ □ Abstract or □ Torrens, please check, one <br />Present use of property: □ Residential □ Other <br />Zoning District: _________ ~ ' " <br />APPLICANT INFORMATION:, (Complex,! <br />Name; q <br />Phone (home): <br />Address: ________________________ <br />Email: <br />I. (Cotnplete,leMl narnfes and marital s^s rMuired for each^intecested party) <br />/fV* M’ fo^r}h ' y _____ <br />________Phone { - -fk):L^ "q - ^ Q %-Ji < ^ <br />________________________________________<*:o Va-//•., r-. ,./j <br />Fax; <br />S'2^ V <br />JWNER INFORMATION: (Complete legal names and marital status required for each interested party) ^ <br />Name: <br />py me (home): <br />Address; __ <br />Email: <br />Phone (work); <br />EXISTING LAND USE: <br />Number of Tax Parcels: <br />Development Size; <br />Fax: <br />/ <br />/ ^ Acres Dry Land <br />. 3 Acres Wet Land <br />/W. Acres TOTAL, all parcels <br />Present Use (check one) <br />Present Zoning District <br />'S' Residential: Number of Units: / 4iot^ *2^ <br />□ Othe’’: (Specify) <br />/-A - / ------------------------ <br />Proposal: <br />□ Division for Tax Purposes <br />□ Lot Line Rearrangement Only (no new building sites) <br />S Subdivision for New Building Sites <br />Number of Building Sites / Existing Units <br />__New Units <br />__Total Units <br />Units per lj4.rS AcresProposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check)'Q Residential <br />□ Other (specify) <br />-10- <br />Square Feet Dry Buildable Land <br />i i ikJ i ^