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City of Orono A <br />Variance Application________ <br />Street Address <br />2750 KeHey ParVway <br />Orono. MN S53S6 <br />Mam 952-249-4600 <br />fax; 952-249-4616 <br />Mailing Address <br />P O. 00x66 <br />Crystal Bay. MN 5S322-‘:066 <br />Application a <br />Dale Received <br />Amount P <br />Staff ______ <br />Fee. S600 <br />Renewal 5300 <br />»atd; <br />U'AlAl- <br />After-the-fact 51,200 Double Fee <br />This application form must be completed in full App cant will be notified withm 15 days as to the status of the <br />appiicauon Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: <br />Site Address: r ^ f rJ *a J^ ^ ________ __________________________ <br />Property Identification Number (PIN); / V // i _____________________________ <br />(Attach legal description to application if not included on the survey.) <br />Date Property Acquired (month/year) V □ Yes. I own the adiacent parcels. <br />Present use of property; ja Residential □ Other _________________________________________ <br />Zoning District: _____________________ <br />APPLICANT INFORMATION: (Complate legal na~es and marital staiuyrquired for each mleresled party) <br />Name: _______________________ <br />Phone (home), i ^/7/~ 7t t/V Phone (work): ___________________________ <br />Address: 4.^ _____________________________________ <br />Email __________________________________________ Pax: _____________________________ <br />OWNER INFORMATION; (Complete legal names s'd mental status required for each inleresled party) <br />Name; /7^'/,vj/s // /s e'e- /k /A/ 'V IjC u c ________________ <br />Phone (home), r V?/- 7d»i/7______ <br />Address: <br />Email;_______________________________ <br />Phone (work). <br />DESCRIPTION OF REQUEST: Estimated Project Cost. <br />Describe the request in detail (attach additional sheets if necessary): _________ <br />To ry>i.LfS W e\^tLc,t.r /Lcrm JCAL-Ty <br />/CyJLf^. /irtl- 'f'O JOr>/\/ l^rU/Ajr.^7c/y <br />#30 56