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City of Orono A <br />Variance Application_____ <br />Sfreef Address <br />2750 Kefley F .rkway <br />Orono. MN 55356 <br />Main 952-249-4600 <br />fax 952-249-4616 <br />Mailing Address: <br />P.O Box 66 <br />Crystal Bay. MN 55323-:066 <br />CW-30SSApplication # <br />Date Received. Q«ZQ-C:>H <br />Amount Paid _________ <br />Staff: <br />Fee;S6C0 <br />Renewal; S303 <br />After-tne-facL S1.200 Douoie Fee <br />This application form must be completed in full App .cant v»rill be notified w.tnin 15 days as to the status of the <br />applicauon Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: _______ loo<; Ofxu-L ___________________________________ <br />Zoning District: <br />APPLICANT INFORMATION; (Complete legal na-es and marital status required for each interested party) <br />Name: a«Vv<r P<-Uriey^ p____________________________ <br />Phone (home): m /A__________________.-Phone (work): ------------- <br />Address:TVJi- <1,^ <br />Email: • <^o >v>_________Fax: <br />OWNER INFORMATION: (Complete legal names s'd marlta: status required for each interested party) <br />Name* •dr )rYv\rX^\^^ _______________________________________Name' Or. _______________________ <br />Phone (home): -SiHi_____________Phone (work): Of//* <br />Address; \o6 ir->i WouJ ^ , (9rrv\0 . >^irQ _______ <br />Email;fj/A Fax: A//A <br />DESCRIPTION OF REQUEST; Estimated Project Cost $ V.Hoo <br />Describe the request in detail (attach additional sheets if necessary): _________________________ <br />locL- <pgv.L<o tv.yj ujc»iIcuoojJ& Crcm ctoo r- dtck- ^ ------- <br />f^a\t\3o 4 ■■ ■■■■• <br />? ‘ ^ f"' • <br />;r.^ .-r fpSt: “• ~ -.s-,X'. <br />4 ^