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City of Orono <br />Variance Application <br />EXHIBIT A <br />Street Address. <br />2750 Kelley Paricway <br />Orono. MN 55356 <br />Man. 952-249-46:0 <br />fax 952-249-4616 <br />Malting Address <br />P.O Box 66 <br />Crystal Bay. MN 55325-!Cc3 <br />Application # 0Q “ <br />DateReceivea __ <br />Amount Pa d ____ <br />Staff. J/'-'i'.r.ir <br />Fee; <br />S bDO 00 <br />S6C0 <br />Renewal: $300 <br />After-tne-fact: 51.200 Coua e Fee <br />This application form must be comp eted m full App cant v; ti be ncttfed w.thin 15 days as to the status of t“e <br />appi cation Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION; <br />Site Address: ____________ <br />—- <br />to <br />7 7.-\\1- 7-^ > 3 I -Property Identification Number (PIN); _ <br />(Attach legal description to application .f not inc ‘-ded on the survey ) <br />Dale Property Acquired (month/year): □ Yes. I own the adjacent parcels. <br />Present use of property: □ R^idenbal ^Other ______I <br />Zoning District Vfc c > <br />APPLICANT INFORMATION: (Complete legai-rjc-cs and mantai status requ red fer each mte'esled parly) <br />Name. tAu.wrs/r., M. . _____________________ <br />Phone (home) - A^ V^H'nne (work): <br />Address. ____ p ' _____________^ _____ <br />OWNE <br />Name <br />EFUNFORMATION: (Complete icga^•arr.es i ' » status repu red for each irtc'ested party) <br />___ ________.___________ <br />Phone (home) ‘H^iwQtk) <br />Address _______ <br />Ernail ^ hd:^ <br />DESCRIPTION OF REQUEST; <br />Describe the^quest in detail (attach additional S".e^ if necessary): <br />n -n-iAT" ofhr /WcLivS ■ iv^ <br />Esiirrated Project Cost <br />pr C , 'TT^ , <br />#3057