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City of Orono <br />Variance 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 />ApplicaUon# Oq - jj/c-P <br />Date Received; <4-is oM <br />Amount Paid: _____ <br />Staff; ' j \ ct. <br />Fee: <br />(IK Se-T <br />S600 <br />Renewal; $300 <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 tho <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: _ i js,______ <br />Property Identification Number (PIN): _o«i \\T2. Zooo a--------•'.................—-w.. V' ii^/. -2. ?.H Z.OQO <br />(Attach legal desciiption to application if not included on the survey.) <br />Date Property Acquired (mon^th/yoar); n /o □ Yes. I own the adjacent parcels <br />Present use of property: ^TResidential □ Other <br />/Zoning District; LjpjL/k___________ ——--------- <br />APPLICANT INFORMATION: (Corr.pleto legal names and marital status required for each interested party) <br />Name: _ ^Ag.*< FA Aouik ( Ao>_irt <br />Pfione (home):____________________ Phone (work): 5^i-»goo <br />Address: ic^o\ 'W^v;yAr*> feL___________ <br />Email.-----. c.n<v-w Fax: Igsz.') .S^l- ifeoo <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name: g ^ je gi. <br />Pfione (home): _________ <br />Address: •2.c> 2.5* StVog-e. T^tz-vt/g. <br />^*^^**‘ -----to ALT, r Pa- P,-TT«flu:.cr. <br />Phone (work): [toX'iS ^oa-8woo <br />Fax: <br />Estimated Project Cost; $ IZO.0OO <br />Describe the request in detail (attach additional sheets if necessary): * ^ <br />----------------—AfTTyy<LtV-cr=> ______________________________ <br />/ff rf^- €% <br />T'- •■'«> .'j V. <br />r/•. M A <br />Kr <br />cr ‘ <br />-•if <br />."J V.. <br />♦V t * <br />\ }.■ <br />.7 "• <br />* A <br />•V