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3*Kibi+A City of Orono <br />Variance Application <br />Sfreef Address: <br />2750 Kelley Parkway <br />Orcno, MN 55356 <br />Main: 952-249-46:C <br />fax; 952-249^6^5 <br />Ma Jmg Address <br />P.O. Box 66 <br />Crystal Bay. MN 55323-:C66 <br />Application# CA‘ 3C.\\ <br />Date Recervefl: - U -c>-1 <br />Amount Pad: '/ cCO • >-X' <br />Staff; ______ <br />Fee:56CX3 <br />Renewal: S300 <br />After-U-.e-fact S1.200 DouQie Fee <br />This application form must be completed in full. App cant will be rctified wi'J'.in 15 days as to the stat-s of fe <br />application Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: ______ <br />Property Identification Number (PIN); <br />^fG5 ‘0 £4:^ <br />(Attach legal description to application if not,included on the survey.) <br />Date Property Acquired (month/year): nlOn □ Yes. I own the adjacent parcels. <br />Present use of property: . ti^Residenlial ' □ Other ____________________________ <br />Zoning District; Vk-1 A <br />APPLICANT INFORiyiA <br />Name:T na^es prd m^ta! s^atus^requjyd for each^interes^M ^ ^ <br />Phone (home)r n /.• ^ Phone (work): /♦ / -7. yLl <br />Address: f " ~ '[ A.u.*->lglr Lri <br />^fjLHA I 11/ p« ^. rcH^ax: " _Email: <br />OWNER INFORMATION: (Comp'ete legal nair.es a-a man'.al s’.atus required for each interested party) <br />Name: T IW cl u (f l 1 f. c I r / ■, 1 b^t. <br />ni------/■--------X. -y, 7-, n,U Phone (^ork): ft l:j 0 ^ -3Phone (home):____ <br />Address: ^ C; <X Pt »(..i j <br />Email: A,? i * i / i! n It f/u flA Fax: ______________________________ <br />DESCRIPTION OF REQUEST: Estimated Project Cost: $ Cr). <br />Describe the request in detail (attach additional sheets if necessary);'.alt'uiiiLi ’it' ilfcrgiv cu ______■ I _'i I/OmBuilaf ' /ir.-ffiJify—l ir\ijs^'- i;DCt-TM <br />^rrfiahi.y'iyj. l,i.Cr\/i! i in r-jL <br />:^ig£2|lM. <br />#30 1 1 <br />h <br />.jMk