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1 <br />City of Orono <br />Variance Application <br />EXHIBIT A <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Application # <br />Date Recaivedi ^ifJi <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Boxes <br />Crystal Bay. MN 55323-0066 <br />Amount Paid: ot <br />Staff: <br />Fee:S600 <br />Renewal: $300 <br />After-the-fact: S1.200 Double Fee <br />This application form must be completed in full. App icant v/ill 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; 4V~7b /\h. ) D <br />Property Identification Number (PIN): 07 - / / 7 - -^ 07 -/ / 7-^7-JV '/)/\ <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): _______Yes, I own the adjacent parcel^. <br />Present use of property; 15^Residential □ Other <br />Zoning District: L.^— ) 1^}__________ <br />APPLICANT INFORMATION: (Complete legal ne.-£s and marital status required for each interested party) <br />Name; _________________________________________________ <br />Phone (home);___________________________Phone (work); __________________________ <br />Address;_______________________________________________ <br />Email:Fax; <br />OWNER l.l^ORMATION: (Complete legal names E'.d marital status required for each interested party) <br />Name; v-,) V> \Ot C-V.ST/i <br />Phone (home); ^SO C Phone (work): (G^A^ (c^)-'9 L^C> 73"? <br />Address: l•~<:t/V^V La\L0 (z;r^u:fiA< . 0 rOv'vOj- j <br />Email; i\. \>\tLC o co. .w\/aI ! [A's Eax; <br />DESCRIPTION OF REQUEST:Estimated Project Cost: $ <br />Describe the request in detail (attach additional sheets if necessa^); _________________________ <br />V'jg \oC(Q^i-pg»^ ri\,i iV ^1 ~(~y^>»■».!"• 0^ jPr*^r <br />^fl0 54 <br />y