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3xV\ibi+A City of Orono <br />Variance Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Application # Q^( ♦ 30 \ \ <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 />Date Received: ^\~Li -Cvj <br />Amount Paid: / fCO. <br />Staff: <br />Fee: S600 <br />Renewal: S300 <br />Aftcr-thc-foct: $1,200 Double Fee <br />This application form must be completed in full. App leant 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;/ <br />Property Identification Number (PIN); <br />(Attach legal description to application if not.included on the survey.) <br />Date Property Acquired (month/year); ^IQ^i □ Yes, I own the adjacent parcels. <br />Present use of property^ ,t5-Residential ' □ OiherV-U,-1 k ---------------------------Zoning District; <br />APPLICANT INFORMATIO.N: Complete legal na.-es_ar}d marital status required for each interested party) -- / <br />Name; t I Hg d ^ CV f H <br />Phone (home); 1 // - Phone (work); <7 - PLj ^«-/ <br />Address; r ,, ,^ if '| Aui/otrlr- <br />Email: (Iffc u.ill r r7^ CWf-fC;. ^0>T^ax: <br />OWNER INFORMATION: (Complete legal names a'd marital status required for each interested party) <br />Name; T 11 /i H i T) cl \ l I f 11 (’ ^)-f r r 11'. /. 111 bf.t. K ^ i'- /.nr. <br />Phono (homo): <br />Address; <br />Email; <br />: 7-, ^yr;c\ gLincI <br />^^/:i if .idr <br />Phone (work); ((■ /p, l( :x t-\ <br /><? Ii.lt' (! P-r-Vfr rlr (ju f-lAFax: <br />DESCRIPTION OF REQUEST: <br />Describe the request in detail (attach additi <br />l/tlriq W dtlc^ U <br />mm'/WA <br />-'fci cc^ ^ ^J T <br />IL <br />Estimated Project Cost: $ ^Q, QSf <br />dditional sheets if necessary): __________________________ <br />ilg r' [;| r> u sr - <br />/ <br />1!o \j9r f-' <br />Vi