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City of Orono <br />Variance Application <br />fex AI <br />Street Address: <br />2750 Kelley Parkway <br />Orono. MN 5535S <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55322-0066 <br />Application # I <br />Date Received • j^i - o<7 <br />Amount Paid: /,-nr’^. f ’c^ <br />Staff: . ' LAt^V. /V /-(L. <br />Fee:S600 __y <br />Renew al- S30J <br />After-the-fact: S1.200 Double Fee <br />This application form must be completed in full. App '.cant 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; 3407 East Lak» Street. Orono. MN 55356 <br />Property Identification Number (PIN): 05-117-23 13 0035 <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): 07/1996 □ Yes, I own the adjacent parcels. <br />Present use of property: E Residential □ Other ______________________________ <br />Zoning District: lr ia ______________ <br />APPLICANT INFORMATION: (Complete legal nsres and marital status required for each interested party) <br />Name: Rebecca Lynn Holr.em <br />Phone (home): 612.801.1140 Phone (work):952.936.5042 <br />Address: 3407 East Lake Street, Orono, MN 55356 <br />Email*. rebecca .holzem^pettersRroup. com Fax:952.936.5050 <br />OWNER INFORMATION: (Complete legal names <br />Nam6! Rebecca Lynn Holzem <br />6*d marital status required for each interested party) <br />Phone (home): 612.801.1140 Phone (work):952.936.5042 <br />Address: 3407 East Lake Street, Orono,MN 55356 <br />Email! rebccca .holzem@pettersRroup. com Fax;952.936.5050 <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ i40.ooo.oo <br />Describe the request in detail (attach additional sheets if necessary): ____________________________ <br />SEE ATTACHED - EXHIBIT A _______________________________ <br /># Q nff JL.4