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City of Orono <br />Variance Application <br />EXHIBIT A <br />Sfreef Address <br />2750 Kelley Parkway <br />Orof^o. MN 55356 <br />952-2^9-4600 <br />fax 952-:49-46l6 <br />f/aJirg AdJress <br />PO Box 66 <br />Crystal Bay. WN 55323-:C66 <br />Appl'cat.cr' * <br />Date P.eceived jo 2c. cw <br />Amount Pa d < <br />Staff <br />Fee S600 <br />Renewal <br />. <V|A iC<^ <br />S300 <br />A*ler-the-fact S1.2DC PcLt e Fee <br />appi.caton form must be completed m fun Ac: cant wll be roMed wiinm t5 days as to me status of me <br />app!.cat.on Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: % | , y P . iv.y <br />Site Address. __________ 2»U5 -----LJi------------------------------------ <br />Property Identification Number (PIN). _____1 1» ir- ~ ---------------------------------------- <br />(Attach legal description to application if not me uded on the survey.) <br />Date Property Acquired (month/year)i T □ Yes. I own the adjacent parcels. <br />P«:esent use of propertyi B Residenlia'. □ O jter _____________________________________ <br />Zoning District _____________________ <br />APPLICANT INFORMATION: (Complete.lega' ra-es ard manta! status rcouired for each rterested party) <br />Name: _____G >-L ^Lcc ---------------------------- <br />Phone (home) __ <br />Add'ess %i'>'________^ <br />Email _______tii*--<^ <br />Phone (work): <br />S i 3 *r *) <br />OWNER INFORMATION: (Complete legal names mantai status 'equired for each interested party) <br />Name ____^g>.». g 0.1 uLjog- —----- — — <br />Phone (home). _______________________ <br />Address______________________________ <br />Email_____________________________ <br />Phone (work). <br />DESCRIPTION OF REQUEST: Estimated Project Cost: .$ ------- <br />Oeser be the request in derail (attach additional sheets if necessary); <v c vo*v-vfc«.»wj <br />^ L.*n <br />.■&: O f A Q,