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City of Orono <br />Variance Application <br />S(r*0f Ac/dWsa. <br />2750 Kefiey Parkway <br />Orono. MN SS356 <br />Main: 0S2-240-4600 <br />fax: 952-2404516 <br />MMngAddnss: <br />P.O. Box 66 <br />Crystal Bay. MN SS3234066 <br />Application# <br />Data Recahred. <br />Amount Paid: Mllm <br />Staff: <br />Foe:MOO <br />Ranawal: S300 <br />After-the-fact t1.200 Doub t Fee <br />This application form must be complotod In fuU. App leant will be notiflad within 15 daya as to tha status of the <br />appueation. Incomplete appilealions wHI not be placed on Planning Commieelon Agendas. <br />PROPERTY INFORMATION: <br />Site Address: <br />/ I/O !_____<Lf(2m>d fuL <br />Property Identification Nurn^(PIN): i I <br />(Attach legal description to application IT not Included on the survey.) <br />Date Property Acquired (month/year): ’3yc?vJ □ Yes. I own the adjacent parcels. <br />Present use of property: □ Residential Other _____________________________________ <br />Zoning District: ___________________ <br />APPLICANT INFORMATION: (Complota Mgal narras and mahtal status required f^ each irterssted pany) <br />Name: ^ <br />Phone (home): Cl- Uni_-^jT Phone (work): <br />Address: d ____________ <br />Email:____iv\A*>/nr f-O Fax: <br />tolT — - <br />COW-I <br />OWNER INFORMATION: (Compiata legal names a*d marttal status requirad for each interested party) <br />Name: ____ ________________________________________________________ <br />Phone (home): <br />Address: ___ <br />Emsil: ______ <br />Phone (work): <br />DESCRIPTION OF REQUEST: Estimated Project Cost $ <br />Describe the request in detail (attach additional sheets if necessary): _______________ <br />•22?* I ■ •'•'i