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City of Orono effflV7tT A- <br />Variance Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono, MN 55356 <br />Main: 952-249-4600 <br />fax: 952-249-4616 <br />Mailing Address: <br />P.O. Box 66 <br />Crystal Bay, MN 55323-0066 <br />Application # 05-3 13 f <br />Date Received : (0;£18 -OS-- <br />Amount Paid : (efJQ, o D <br />Staff : fvC.tJOs...n,i :L <br />Fee: _$~6:....:0....::.0 ______ _ <br />Renewal : $300 --'------:-------A ft er -the-fact: $1,200 Double Fee <br />This application form must be completed in full. Ap~:icant will be notified within 15 days as to the status of the <br />application . Incomplete applications will not be placed on Planning Commission Agendas. <br />PROPERTY INFORMATION: d <br />Site Address: t:o]{Q 6d..idu r Po..r k:. £ <br />Property Identification Number (PIN): <br />(Attach legal description to application if not included on the survey .) <br />Date Property Acquired (month/year): 3/JtJo2. □ Yes, I own the adjacent parcels . <br />Present use of property: □ Residential □ Other _________________ _ <br />Zoning District: <br />APPLICANT INFORMATION: (Complete legal na:-:-:es and marital status required for each interested party) <br />Name : PA=n k c t::c ~ 12 61:J L?tt· e, V\ UhJ,6± G 3~ L <br />Phone (home): 6 /2--5'81-35..).7 Phone (work): _____.5a""""""',..=c...Jtt ..... 1....,e=--,~------ <br />Address: QI H-0 Ci:v,eeV1 wood uil"cle (rJl.e.e0 u./de;& µ) V) • S-5?3 / <br />Email: D&0i.f.j Lay-k:.,1-V' q; AA 5 V , /'t:J n--i Fax: '2,s:2..-~t:J/-jf79~ <br />OWNER INFORMATION: (Complete legal names a:;d marital status required for each interested party) <br />Name: ~ t1dV"~ 5-en':So D <br />Phone (home): C(S~-~3S-/'-IC/ z Phone (work): <br />Address: J3 ]fR ·6aldL)r P,(; o,.,J. O/'IJP10 <br />Email: ___________________ Fax: ____________ _ <br />DESCRIPTION OF REQUEST: Estimated Project Cost: <br />Describe the request in detail (attach additional.sheets if necessary): <br />1, <br />Ii <br />-~ f.:r-. ~\1 \:i:'..., -r, <br />r ,· <br />02,f;