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City of Orono <br />Variance Application <br />EXHIBIT A <br />S:net Adiress <br />2750 Kei'.ey Parkway <br />Orcno. MN 55355 <br />Ma^n 952-243-4600 <br />fax 952-245-4516 <br />Ma 'ing Address <br />PO Box 66 <br />Crystal Bay. MN 55323--OS6 <br />Application # <br />Date Received <br />Amount Paid ikcc Cc <br />Staff. __________ <br />Fee:S600 <br />Renewal $300 <br />After-tne-fact Si 2C0 Jcus e Fee <br />Tnis application term must be completed m fuG App cant v.nu be nctified wiOrn 15 day* as to the status of tr’e <br />application Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: , . , <br />Site Address; <^V~7ST LMn.e^t i _ <br />Property Identirication Number (PIN): P 7 -/I7 t <br />(AUach legal description to application if not inc uded on the survey.) <br />Date Property Acquired (month/year): _______Qd Yes. I own the adjacent parcels <br />Present use of property; l5*^Resldential □ Other_________________________ <br />Zoning District; \ _________ <br />Cl <br />APPl iCANT INFORMATION: (Complete legal na-es and rrantal status required for each interested party) <br />Name: <.u3, iatV^ >..7________________________________________________________ <br />Phene (home); <br />Address; ___ <br />Email; _____ <br />Phone (work); <br />OWNER UJ4FORMATION: JComptete legal names e'd mantai status requ red fdr each interested party) <br />Name; ■^C^cuV ^\rytJcST>iiV iiV-AL <br />Phone (home); ~ ;^s~^s ___ <br />Address- l-<r/v^V L u\lo (/.v»ngfiA <br />Email; V c> cc . > la S Psx; <br />Phone (work): ^9 7^~7 <br />0 <br />DESCRIPTION OF REQUEST:Estimated Project Cost $ <br />Describe the request in detail (attach additional sheets if necessary): _ <br />LcA" LOu.MOv uvO-»~ *r 4jc • tah p? ______ <br />\acn'X-**i:X riA ~i.^ ef^ <br />..iia iiifeifei