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CityofOrono A <br />Subdivision Application <br />Strvtf Addrus. <br />2750 Ketley Parkway <br />OroiV). MN 55356 <br />Mam 952-249-460C <br />fax 952-249-4610 <br />M§ikng Addnss <br />P O. Box 66 <br />Crystal Bay. MN 55323-0066 <br />This application form must bo completad in full. <br />Application # <br />Date Received 7 -n <br />Amount Paid x-7P.. <br />Staff <br />Fee <br />Renewal' <br />Vvi <br />PROPERTY INFORMATION: <br />Site Addreas: |\QO T~c***-^*^ vc- <br />Property Identification Number (PIN) <br />(Attach legal description to application if not included on the survey.) . <br />Date Property Acquired (monttVyear)- □ Abstract or a Torrens, please check one <br />Pnatnt use of property: H Residential □ Other <br />Zoning District RR \ A <br />APPUCAI^ INFORMATION: (Complete legal names and manta! status required for each interested party) <br />Phone (home): 7^i - - ilt-qq________ <br />Address: I too >we, rA A^*nt» ON a C vn <br />Emaa: ^ Fa <br />Phore (work)- <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested parly) <br />Name: a O \ cv> <br />Phone (home); 7 0.1 “2 q <br />Address: noo Vxv,t* c -a <br />Emal: <br />__Phone (work); <br />EXISTING LAND USE: <br />Number of Tax Parcels: <br />Development Size: <br />I <br />/.l.gl <br />13. <br />Acres Dry Land <br />Acres Wet Land <br />Acres TOTAL, all parcels <br />Praaent Use (check one) ^ Residential; Number of Units: (h <br />□ Other. (Specify) ________^ <br />Present Zoning District t in________ <br />Proposal: <br />□ Division for Tax Purposes <br />□ Lot Line Rearrangement Only (no new building sites) <br />0 Subdivision for New Building Sites <br />Number of Building Sites / <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check)Wi <br />I <br />^0 <br />L_ <br />Residential <br />□ Other (specify) <br />.10. <br />Existing Units <br />New Units <br />Total Units <br />Units per 0*^ Acres <br />Square Feet Dry Buildable Land <br />MOQ QQ <br />tAvmnuk,