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City of Orono <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. Box66 <br />Crystal Bay, MN 55323-0066 <br />Application # <br />Date Received : <br />Staff: <br />Fee : <br />Escrow : <br />Notes: <br />Please complete. Applicant will be notified within 15 days as to the status of the application. <br />Incomplete applications will not be placed on Planning Commission Agenda. <br />SITE LOCATION: \ "'Joo ~JIS fotNt ~C>AP I a\?4No M,H, '25"129 I <br />DESCRIPTION OF REQUEST: -"""6..._E ...... ii-__._A .... ::ll7rt:.......,...,.u~eo"'"'""' ___________________ _ <br />(attach additional sheets as necessary) <br />APPLICANT INFORMATION: D check here if Applicant address should be used for billing <br />Applicant: ,\EAN J?t:t:\l'b.MP kAA,$4N <br />Phone (Primary): ?, ,z.. 2 s;: .7-z.. 7 S: <br />Mailing Address : '27~1. wssr: ~3ie.o $T City: M.\?k'2 <br />Email: .... u;;:ti1t:l e, J2$\i)'..AMf'k,AC?.SON . C-o y\ <br />PROPERTY OWNER INFORMATION: D check here if Property Owner is same as applicant <br />)( check here if Property Owner address should be used for billing <br />Name : e,1=.021;,.i;.. t\A,L.)lc>~,4 <br />Phone (Primary): <br />Mailing Address : City: ZIP : <br />Email : <br />APPLICANT AND/OR PROPERTY OWNER: <br />• Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and property owner <br />recognize that they are solely responsible for submitting a complete application being aware that upon failure to do so, the <br />staff has no alternative but to reject it until it is complete or to recommend the request for denial of the request regardless <br />of its potential merit. <br />• The Property Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the <br />property by City Staff, consultants, agents, Commission and Council Members for purposes of investigation and verification <br />of this request. <br />• Property Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the Planning <br />Commission and Council. If an applicant and/or property owner is unable to attend a scheduled meeting, please make <br />arrangements to have an authorized representative attend in place of the applicant/owner and advise the City Planner <br />assigned to your project. <br />• <br />Applicant Signature: Date: ,i · 1;~1.1: <br />Applicant Signature: Date : <br />Date : /Z·/3·tr RECEIVED <br />Date : DEC 1 3 2017 <br />3 997 Pag e 4 ,. J1, .,. ·l· C11Y OF ORONO <br />Property Owner Signature: <br />Varian ce Application -January 2017