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r City of Orono <br />Variance Application <br />EXHIBIT A <br />StrMt Address: <br />2750 Kelley ParKway <br />Orono. MN 55356 <br />Application^ <br />\ 2- g)0- o3 <br />Main: 952-249-4600 <br />fax: 652-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay. MN 55323-3066 <br />Date Received. <br />Amount Paidj. l;00 ^ o <br />Staff: <br />Fee:-4; <br />Renewal; 5300 <br />After-the-fact S1.20C Double Fee <br />This application fbrm must be completed in full. App'cart will be notified witnin 15 days as to tfe status of the <br />application. Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION:./ k <br />Site Address: Jy/: <br />Property Identification Number (PIN): <br />(Attach legal description to application if rjo^cluded on the survey.) <br />Present use of propeiW: ^ Reside <br />Zoning District: <br />ResiOenlxa^/ □ O'Jier <br />I own the adjacent parcels. <br />APPLICAN <br />Name: <br />WiNFORMATI <br />lome): ^ <br />TION: (Complete legal nares and marital status r^uired for each interested party) <br />PClX") r4 evs— <br />^ ^ LPhone (home): v Phone (wc^)/ <br />Address: <br />Email: _______________ <br />^ ^ J^/0 - <br />Fax; <br />OWNER INFORMATION: (Coraplete legal names a*d marital status required for each interested party) <br />Name: i ___________________ _______________________ <br />_________________________Phone (work): ______________________Phone (home): <br />Address: <br />Email: <br />DESCRIPTION OF REQUEST: Estimated Project Cost <br />Describe the request in detail (attach additional sheets if nece^ry): <br />^ l<>T. > rvb <br />jflT/A <br />i^ry):____. <br />Jj iki <br />#2981