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EXHIBIT A <br />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 55323-0066 <br />Application # V <br />Date Received. *7- Z.I ~ <br />Amount Paid: fjQ Q- _____ <br />Staff; 3a n i'- <br />Fee.S600 <br />Renewal; $300 <br />After-the-fact; Si.200 Double Fee <br />This application form must be completed in full. App'cant v/ill be notified within 15 days as to the status of the <br />application. Incomplete applications wilt not be placed on Planning Commission Agendas. <br />PROPERTY INFORMA-nON: ^7 ^ <br />Site Address: 7/4^^ Y 4-'‘C <br />Property Identification Number (PIN): f S- //?■ ^ ^ - I <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): //-o'Z. □ Yes, 1 own the adjacent parcels. <br />Present use of property; '^Residential □ Other __________________________ <br />Zoning District: ____________________ <br />APPLICANT,INFORMAT^N: (Complete legal ns.-ss and marital status required for each interested party) <br />Name; S/ _______ <br />Phone (home); ^ y/- 6 0 7/ <br />Add'ess: \9'ZT <br />Email; <br />Phone (work): ^ /Z- <br />Fax; <br />OWNER INFORMATION: (Complete legal names e*d marital status required for each interested party) <br />Name: \ <br />Phone (home); <br />Address; rhemJ Arr^. <br />Email- ^ <br />Phone (work): <br />Fax- <br />DESCRIPTION OF REQUEST; Estimated Project Cost. <br />Describe the request in detail (attach additional sheets if necessary): <br />$ <br />^ h:n(Ltr\n I'yCr KC fZH.cUi'r^ ^ iis rr rLx.cf'tU <br />nr\^l-rh\ <br />(jur'urhh)-i IS-ww* ^ppLtiLA J iLfiii hf_ a~ /6,/Cla3=0 <br />#30 44