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PC ExhibitA <br />City of Orono <br />Subdivision 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 # l ~ -3 5 '1 J <br />Date Received: / -;:;, ,&-! _ 3 <br />Amount Paid : U l '2.J.& tf <br />Staff : ~l, ~ Fee: 4illi--=-· -H-,,,~,,....,.,...,q----- <br />Renewal: <br />This application form must be completed in full. <br />Site Address: <br />PROPEitTY INFORMATION: <br />Ou}\ c-t-C.. <br />Property Identification Number (PIN): _Qlp~~'-1-1 ...... 3--=3~4-d.........,cci__.S'~--------------- <br />(Attach legal description to application if not include on the survey.) <br />Date P~?perty Acquired (month/year): ~ 1qq D Abstr~ct ,or'© Torrens, please check one <br />Preser:t.t use of property: (} D Residential ~ Other eJ.{1S,\\C4 Qw\ o+ <br />Zanin~· District: ~'°' -\ ~ -~~~--+~~~~---------- <br />APPLICANT INFORMATION: (_Complete legal names and marital status required for each interested party) <br />Name : [,yi (\ ~ C..nrY)O.("\ <br />Phone {home): ~eu..: (p 12. -'-J " -2ogq Phone (work): <br />Address : a,:5 §\ e.m CoGi-\-t-00fj 1-a\:.e th 0 <br />Email : .,:hellwub v:i @ "'iSI'\. cu"'"' <br />1 <br />Fax: <br />OWNER INFORMATION: (Complete legal names and marital status required for each in terested party) <br />Name: ~rn~ O.b 0..W~ <br />Phone (home): Phon e (work): <br />Addr~ss : • 4-,: ~ cJo q ~ <br />E~,ti I ~; ii;;,ic;;f;,l'iikkw-n,,:J-LoY'-J Fax ei,,,., . <br />EXISTING LAND USE: U <br />l Number of Tax Parcels: <br />.1Pd:::,()ILO I ~ t-rvl <br />l!YlRI s~i €-'s-a_--k.. re . Ee>VV\ <br />Development Size : \S .O\ Acres Dry Land <br />D, 1 \ Acres Wet Land <br />\&. t"f d, Acres TOTAL, all parce ls <br />Present Use (check one) <br />Present Zoning District <br />Proposal: <br />0 Residential ; Number of Units: ~~_of g: (Specify) -~__..__\S~~--n__,j.--C)_u.}_\D\-________ _ <br />0 Division for Tax Purposes <br />0 Lot Line Rearrangement Only (no new building sites) <br />-¢-Subdivision for New Building Sites <br />Number of Building Sites O Existing Units <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check) <br />5 New Units <br />5 Total Units 'i Units per 13 .1 d.. Acres .::.. <br />81 .\CS Square Feet Dry Buildab le Land <br />1$ Residential <br />D Other (specify) <br />Su bd ivision Application Last Updated: N ovember 2010 <br />10 <br />D .4 u (o.c. <br />RECEIVED <br />JAN 2 3 2013 <br />ClTY OF ORONO <br />#3591