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VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />(Complete in Duplicate) <br />This form to be used in all applications for special use permits and <br />for rezoning, dividing or consolidating parcels of land, vacating <br />streets, alleys and variances. <br />Type of Application /i r K \/d. rt d Date.^;3/^ <br />Owner of Property: Name d'n Phone No. <br />Address ^ _ _ _ _ ___ _ <br />Applicant (other than owner): Name _ _ _ Plwne No. , —— <br />Address /^4-aa^ <br />Relationship to Owner u J ir <br />Engineer: Name_ _ <br />Land Planner: Name <br />Subdivider: Name <br />Phone No. <br />Phone No. <br />Phone No. <br />Location (How do we find it?) <br />Legal Description: <br />Date Acquire d <br />Lc-h 0-f> <br />Area (sq.ft.)Single" 0^ershi <br />Separate Ownership <br />Date of last division of this property_ <br />Do you own any adjoining property i <br />Action Requested <br />o <br />Signature of Applicant <br />RECORD OF ACTION TAKEN <br />Date <br />Inspection Dept.: <br />Administrator: <br />Village Council: <br />Village Engineer: <br />Village Attorney: <br />Planning' Commission: <br />VilKage Council: <br />P«rmi\t I ?ueid: Date <br />-r.j A <br />u. / y. <br />Action <br />Lt f <br />G> <br />c i <br />Lt r ^