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EXHIBIT A <br />City of Orono <br />Variance Application <br />Sfrss! Address <br />2750 Ke.Iey Parkway <br />Orono, MN 55256 <br />Main: C52 2<9 <^600 <br />fax 952-249-4616 <br />Mailing Address: <br />P.O Box 68 <br />Crystal Bay. MN 55323-C065 <br />Aooi’calion H (0<-l ^3c>3C/:> <br />Dale Received /,j, <br />Amount Paid; (_^-cCv i T> <br />Staff: <br />Fee; SSto <br />Renewal 5300 <br />Aftsr-tha-fact; Si.200 Do-trie Fee <br />This application form must be completed in full. Applicant will be notified within 15 days as to the status of me <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION:rr^wi-tcrM t iixrurxiviM IJ.UIN: fs n <br />Site Address: <br />Property Identification Nurriber (PIN): 3 i)^ ' <br />{Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): ________ □ Yes, I own the adjacent parcels. <br />Present use of property: £3^Residential □ Other___ <br />Zoning District: <br />___ ^ __________ Phone (work):' ______________ <br />Address: h s> t~ t>A^vtS <br />dfVO 6-^ AI 11- r Cm'j |~,crr7/<V___________ Fax: “P—^ ~ 6 <br />j-o»D 1 r\Ca-pi>^ <br />OWNER INFORMATION; (Complete legal names and marital status required for each interested parry) <br />Name; R.T':^nl<<> (s)__________________ <br />Phone (hone): Qb“5>- 1^7 3 --OO Si "y <br />Address. 3~7i3_s u.* firO <br />Email: <br />Phone (work): 7 3 j j <br />Fax; <br />DESCRIPTION OF REQUEST: Estimated Project Cost: S <br />Describe the request in detail (attach additional sheets if necessary); i Ji. q q <br />j CL-V-^ .c-i^ C<T__}rU^ .9 L'a fa f rZT <br />__Scrhf\-<-('\i only )V(bi-v* li'clrTM: h iJ t t, , . -. -----^----------------------------------o nl^ fi ' dt>rAc K t<J J f <br />g-g I tP V—(Q. i' F-cP fK <? <br />Lit- f4w n Art •ft X .^3Ai-\jTZrTA -^.1 a j _1. o'^ ~ <br />—Caj\.. .^AArt^C^.. fa tvlIV-■ - /(O-r q rirm errh y^ jr ., <br />4;^!, QuiTh^ —Cl. ^ I_____________________ ^ C <br />Oi O <br />[ - t «V J ^ 2