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EXHIBIT A <br />Application # ^____ <br />Date Received <br />Amount Paid <br />CITY OF OKONO - VARIANCE APPLICATION <br />Initial Application Fee $250.00 • <br />($50.00 per each additional variance) <br />Renewal Variance Fee $150.00 <br />(no change from original application) <br />Variance for non-conforming structures $250.00 <br />After-the-Fact Fees (Double application fee) <br />PROPERTY INFORMATION <br />Site Address H\D0 /{dA^ <br />000^Property Identification Number (P.I.D.).________ <br />Attach legal description to application if not included on required survey. <br />Date Property Acquired__________b(\o^ ^ ^_______________________(month/year) <br />I (do noO also own the adjacent parcels of land. <br />Present lisT^f property: residential ___pother (specify) _________________ <br />ZoningPistrict: _________________________________________________— <br />APPLICANT <br />Name A). SMoU. <br />Address: SfOQ uIa-TFI^tpu )/V <br />■ Phone (home)_tUt}lzJI2d — <br />_____ Phone (work)___________ <br />City: OR oi O d _________Zip: <br />O^VNER (if different than applicant) <br />Name _________^ <br />Address: <br />Phone (home) <br />Phone (work)_ <br />City:.Zip: <br />Estimated Construction Cost $DESCRIPTION OF REQUEST __________ <br />Describe request in detail: |S3ioa/ ^ <br />(attach iiieets if A?cess^) . <br />RtGiUfeSriK3fr Cocwa^ OM ‘jaMcS- <br />VARIANCES REQUIRED ... <br />Lot Area Lot Width Hardcover ___Lot Coverage <br />iif ^12) <br />i) * cJ <br />It <br />Setback:Front Side Rear Average Lakeshore <br />Other (specify) <br />HARDSfflP/DESCRIPTION OF UNTJSUAL PROPERTY CONT)ITIONS <br />Describe undue hardship or practical difficulty or imusual property conditions preventing <br />compliance with Zoning Code requirements:_________________________________— <br />(attach additional sheets if necessary)