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City of Orono ^ <br />Variance Application_______ <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-C066 <br />Application # ^>0^^ <br />Date Received, (yj 7J 0 <br />Amount Paid: & (fuD-r' <br />Staff; HUHlJuJ. <br />Fee: S600 <br />t'U <br />Renewal; S300 <br />After-the-fact; $1,200 Double Fee <br />This application form must be completed in full. App icant will bb 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; /. /L/a.' ST^v / <br />Property Identification Number (PIN): <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; .<£1 Residential □ Other ______________________________ <br />Zoning District; ______________________ <br />APPLICANT INFORMATION: (Complete legal nc~es and marital status required for each interested party) <br />Name; t^s /feu >'-/_________________________________________ <br />Phone (home); <p<Z __________Phone (work); <br />Address; c*A>yS Pi.-^ /iWi'd. ______________ <br />Email. ty/t n^,-1 /-J ^ ri Fax; <br />OWNER INFORMATION: (Complete legal names e*d marital status required for each interested party) <br />Name; '^yc ftn i /w.i /e s f ^ <br />Phone (home); y< .S s :> ji:Phone (work); /.,} ry^r. <br />Address;• L-/S” /?, y I't/ A •* . -■*>*> '» 7 ’ <br />Email; /irl,;. yt-.t-x •*' if.'y , i,., .' t Fax; <br />f J , V .■ » . , J <br />DESCRIPTION OF REQUEST: Estimated Project Cost; $ <br />Describe the request in detail (attach additional sheets if necessary); ____________________________ <br />f in/n.^cn'Cl u:-c‘C~ d <br />if • • <br />. jai—rw.