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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 68 <br />Crystal Bay, MN 5532S-C066 <br />Application # <br />Date Received. <br />Amount Paid; _11OO■ ^P/3 <br />Staff . <br />Fee; S600 <br />Renewal; S300 <br />After-the-fact; Si.200 Double Fee <br />This application form must be completed in full. App'.cant will be notified within 15 days as to tne status of the <br />application, incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: . ^ <br />Site Address; 32.S <br />Property Identification Number (PIN); <br />(Attach legal description to application if riot included on the survey.) <br />Date Property Acquired (month/year): ^ ‘‘‘ f"' *hp <br />Present use of property; Ja^Residential <br />Zoning District; __________________ <br />0 T □ Yes, 1 own the adjacent parcels. <br />U Other <br />^PPLICANT INFORMATION: (Complete legal narres and marital status required for each interested party) <br />ame; 6u\\.iVgLn _____________________c.za\ - gcyb3 <br />Phone (home)i rJ^lL^ <br />Address; ^4oq tT-iATR Au S> <br />email: • LOSottVio&-Ai-0 com <br />______Phone (work): (fatT-’) z.oS-5~q^9 <br />M poli4» I KA<4 SS40Cg___________ <br />Fax; (foOS**oi^^ <br />OWNER INFORMATION: (Complete legal names c.'d marital status required for each interested party) <br />Name; V\;c»v\'f ______________ <br />Phone (home); ^ W V^I Phone (work): jr\ i > p’O^TT-zAHi j <br />Address; ?iH0*I •? ______.clvwtMLr*. pAlia , ^/j4b(r____________^ <br />Email; luwV.V.>vc<-'.v.V(^. twov- rv-(t> _______ L»oS~0*^** <br />DESCRIPTION OF REQUEST: Estimated Pra^c» Cost: $ :3^73.0oD <br />Describe the request in detail (attach additional sheets if necessary): __________________________ <br />\ c Q. 6ucr^- CU\S‘ 'u- 0-Ct~p <^c ,t L-(U’^i 1'0 ____ <br />'y-VAvUiii fi C*3v--VU. bsn-i.r> uJa..[K6i^t <br />_CLv^rA. 'll f/j AJl" ? tj .f-.- 'I'l'v r (^4 ________________________________ <br />-C"' 71^\J 4