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city of Orono <br />Variance Application <br />EXHIBIT A <br />Stnet Addnss: <br />27S0 Kelley ParVwsy <br />Orono. MN 55356 <br />Main 9S2-249-4eC0 <br />fax 952-249-4615 <br />Maying r^ddnss <br />P.O Box 66 <br />Crystal Bay. MN 55323-:066 <br />Application # ^ 2.^ <br />Date Received. 0109^0*4 <br />Amount Paid: I^CJQ. c/t? <br />Staff: ____________________ <br />Fee: “S606 ~ <br />Renewal: S300_____________ <br />Afler-the-facL Si.200 Doub'e Fee <br />This application form must be completed in full. Applcant will be notified within 15 days as to the status of the <br />appScation. Incomplete applications will not be placed on Planning Commisaion Agendas. <br />PROPERTY INFORMATION: . , <br />Site Address: / <br />Property Identification Number (PIN): __________________ ____ <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year): /jSI □ Yes, I own the adjacent parcels. <br />Present use of property: ^ Residential □ 0*iher_________________________________ <br />Zoning District: _____i __________ <br />APPLICANT INFORMATION: (Complete lepa! ra.-es and martal status required for each interested pa-Ty) <br />Name: C^£Ur\jCQ ^ ? Ly/o kL sJohn^n <br />Phone (home): <br />Address: TjT 61 <br />Emaih <br />IPH-Phone (work): <br />Fax: <br />OWNER INFORMATION: (Complete legal names I'd mahtal status required for each interested part)) <br />Name: QcUr\(CO ^ ^ Lu\-c John^n <br />Phone (home): Jj <br />Address: ‘Ut ~T <br />las'll Phone <br />f^uin/-} An/^ 4 Mpti r/5’^ <br />Email: <br />DESCRIPTION OF REQUEST: Estimated Project Cost <br />Describe the request in detail (attach additional sheets If necessary):____________ <br />■•»•<#* 'I