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City of Orono <br />Variance Application <br />EXHIBIT A <br />Sfreef Address. <br />2750 Kelley Parkway <br />Orono. MN £5356 <br />Mam 952-249^600 <br />fax 952-249-4513 <br />Mailing Address <br />P O Box 66 <br />Cf>5tal Bay. MN 55322-:065 - <br />Apo >cation# ^0^3 <br />Date Received <br />Afrount Paid '^nr-i <br />S*3ff. <br />fe" <br />enewa! S503^ <br />ina ioe! ,2C3 Deuc e Fee <br />Ths application form must be completed in hjli. App cant wriii be not f.ed within 15 days as to the status of tne <br />application. Incomplete applications wiil not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: r *s » ,n j <br />Site Address; Soo (*^YC\r\0>Jrd rOlYk- <br />Property Identification Number (PIN); “SZ — II ^ '2 3 - 2 3^ OOP 3 <br />(Attach legal description to application if not included on tne survey.) <br />Date Property Acquired (month/year); lo/iRfefi□ Yes. I own the adjacent parcels. <br />Present use of property: IH^esidential □ Other ____________________________ <br />Zoning District. _____________________ <br />APPLICANT INFORMATION: .(Comqiete legal n2“€s_ahd mantai status redjir^ for each interested pahy) <br />Name; ~^cv»VAS ^AoiW\S <br />Phone (home) L.-O V73 <br />Address: goo QYg.Vva>rd <br />Email: i^ynSrsOur^p?rawci53 <br />vTaV\-e44< iXf. <br />Phone (work): <br />6 <br />-27!^^2~s< <br />• roniA Fax; <br />OWNER INFORMATION: (Complete legal names a-d rrahtai status required foreacn interested party) <br />Name; ____________________ ______ <br />Phone (home): <br />Address: ____ <br />Email: <br />Phone (work): <br />Fax: <br />DESCRIPTION OF REQUEST: Estimated Project Cost $ <br />Describe the request in detail (attach additional sheets if necessary): _________________ <br />n 1