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City of Orom <br />Variance Application <br />Streef Addnss: <br />2750 Kelley Par>(way <br />Orono. MN 55356 <br />Main: 952*249-4600 <br />fax 952-249-4616 <br />Mailing Addnss <br />P.O.Box 66 <br />Crystal Bay. MN 55323-:066 <br />AppUcabon# <br />Date Recehred' <br />Amount Paid; <br />Staff <br />Fee: <br />Renewal:S300 <br />Aner-the-fact 51 200 Double Fee <br />IfHS application form must be completed in fu5. App leant will be nobfled 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: ID t>>rrv4/iL Rrvirl Ofono MfJ 5535 <br />Property Identificaton Number (PIN): eJr^ -//7 - ^ *-/3 <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (monttVyear): 7/^.^ □ Yes, I own the adjacent parcels. <br />Present use of property: XResidential <br />Zoning District: _________________ <br />□ Oiher <br />APPLICANT INFORMATION: (Complete legal names arid marital status required for each interested party) <br />Name: VAnnnACfc <br />Phone (horneV <br />Address: ^ <br />Email: ht^b A <br />Phone (work): <br />a/a/ <br />OWNER INFORMATION: (Complete legal names sra mamal status required for each interested party) <br />Name: Ajlnrvj <br />_ Phone (work): toO o <br />g e4Jx4/t^b0. /ytA/ s‘S39y <br />Phone (home): <br />Address: <br />Email: fpPkt /O J*y /*/? rr-7 Fax: <br />DESCRIPTION OF REQUEST: Estmated Project Cost: $ <br />Describe the request in detail (attach additional sheets if necessary): _______________ <br />44rr t -.* fj