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City of Orono <br />Variance Application <br />exHxe. ir A <br />Street Address: <br />2750 Kelley Parkway <br />Orono. MN 55356 <br />V^iV <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 # ^ <br />Date Receiverl /Xl/y <br />Amount Paid:./r h)f ir' Os <br />Staff: _iWTTuTiCL <br />Fee:S600 <br />Renewal: S300 <br />After-the-fact; 51,200 Double Fee <br />This application form must be completed in full. App '.cant vnli 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: ^70 ,/ <br />Property Identification Number (PIN): <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): ^ - ‘fc) □ Yes, I own the adjacent parcels, <br />Present use of property: □ Residential □ Other____________________________ <br />Zoning District: / (P. - ! _________ <br />APPLICANT INFORMATION: (Complete legal nares and marital status required for each interested party) <br />Name: ~7Tl^ ,>~ri___________________________ <br />Phone (home): v- <*✓'?/ -- Phone (work): ________________________ <br />Address: ’K- . r-~rt-. - 7.,.:/?._____________________________________________ <br />Email:________________________Fax: <br />OWNER INFORMATION: (Complete legal names a-d marital status required for each interested party) <br />Name: ____________________ ____________________ <br />Phone (home): <br />Address: ___ <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): ~r^ _____'