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Fee /.S. c v <br />Case No. _ <br />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 <br />Owner of Property: <br />-------------- <br />4 ire <br />Name Z 6. <br />Address A.0 A�%.t 1q <br />Applicant (other than owner): Name <br />Address <br />Relationship to Owner <br />Date -6-- r-3 -69 <br />Phone No._ <br />one No. <br />Engineer: Name Phone No. <br />Land Planner: Name Phone No. <br />Subdivider: Name_ Phone No. <br />Location (How do we find it?)�PCA Sco KYl% <br />Legal Description:, 17 ago -,2SOn (!&5e. t! Aln - J7A-5 <br />bingieuuwnersni <br />Date Acquired Area (sq.ft.) Separate OwnersK p <br />Date of last division of this property <br />Do you own any adjoining property /1/U <br />Action Requested /erm r .fi n rQ z p n /� A /Va "i e, 13H l', <br />Inspection Dept:: <br />Administrator: <br />Village Council: <br />Village Engineer: <br />Village Attorney: <br />Planning Commission: <br />Village Council: <br />Permit Issued: Date <br />`' <br />Signature of Applicant <br />RECORD OF ACTION TAKEN <br />Date Action <br />C <br />r✓ e <br />