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City of Orono <br />Variance Application <br />EXHIBIT A <br />St'eer ACdress: <br />2750 Keliey Parkway <br />Orono. MN 55355 <br />Application <br />Date Received; t_c 'i.i-oW <br />Main: 952-249-^500 <br />fax; 952-249-^516 <br />Mailing Address <br />P.O. Boxes <br />Crystal Bay. MN 55323-0066 <br />Amount Paid. LcCxZ>. CO <br />Staff: ^ j fx \ ; r u- ^_______ <br />Fee:S6C0 <br />Renewal; S300 <br />Afte.*-the-fact' 51,200 D cud e Fee <br />Th'S application form must be completed in full. Appicant will be notified within 15 days as to the status of thf <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address; <br />Property Identification Number (PIN); 1 - 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: ,13vResidential □ Other <br />Zoning District; L-g -l __________ <br />APPLICANT INFORMATIO <br />Name; PhOrleS ^ <br />'ll (Complete legal names and marital status reauired for each interested party) <br />Phone (home^; C <br />fiPiSr&Cl VI rn € 1 M CirfeCl-1'^_________.__________________________________ __________________________________________... <br />'Cl ) Phone (Work); -/Ml..-L-M I 2 <br />Address; olC^CiS ^ / Ar^c-^ <br />Email- Cli^lHA<^,^?^itMl^dle,Ol-^ c?) hpSe/;i~j Fax: <br />• sj <br />OWNER INFORMATION; (Complete legal names s'd mantal status required for each interested party) <br />Name; <br />Phone (home): <br />Address; ___ <br />Email: <br />Phone (work); <br />Fax; <br />DESCRIPTION OF REQUEST: ' Esti.maled Project Cost $ <br />Describe the request in detail (attach additional sheets if necessary). _____________ <br />U.\\OTVr ~ 1*^0? "TH'.Ah-.l . "Z^-su/n yV <br />o kJrrP lU <br />^-f ! rTU^-Jy.::- <br />li < ■ ; <br />\ <br />.•:O 0 'A..-?: <br />4 <br />^ C -5 <br />I