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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. Box 66
<br />Crystal Bay, MN 55323-0066
<br />Application# l 2--~
<br />Date Received: ------
<br />Staff: CM ~-------Fee: $700 --'--------Renew a I: $350 --'--------After-the-fact: $1,400 Double Fee
<br />Escrow Fee: $600 / $2,500
<br />This application form must be completed in full. Applicant 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: (
<br />Site Address: B(l..,...., ,J Q.oR'b (\J.,a.,114-ND"ll(l.e~.5 ~t'1"~S"'-~~)
<br />Property Identification Number (PIN): _..,..?---''f_l~1.&--=Z'--'3_11_o:c........c..o_c;o...,.1"---------------
<br />Date Property Acquired (month/year): l, / 02,. '1 Yes, I own the adjacent parce11,
<br />Zoning District: L..Q.-l /c ' -7Ko N, -e,(2.ow,,1 12.ol?l>
<br />-3'-111 Y,. 2.. s II oo-o 2-
<br />APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party)
<br />Name: ol,l.~ 7) t-"P ,-t-~t:,c; M rr"vt(;
<br />Phone (home): 9S::z .. '-(7(, .. ,..,, Phone (work): l-1 t..-'"LS:-Z'-fK£
<br />Complete Address: 780 N , oil.or' H '2.o~"'z>
<br />City, State & ZIP Lo,J ~ 1.A~ M~ 5S::sS"C
<br />Email: ;rs,.-,-v,G, @. 1,,.A,v\N, e:bu Fax: G,l1..-lzL/-Zo~l.,
<br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party)
<br />Name: o\\tl 1:> +--Pl-loeE,E ,-.,t\/t
<br />Phone (home): 9<;2 -L(,G,-I II, Phone (work):
<br />Complete Address: 7~r:;, ,..S. oR.owN /:4,/?b
<br />City, State & ZIP Lo~ L.-J'rl(.e M,J S:~s5:l
<br />Email: :fST&v'tC. e_ VMaJ, €'i>Vl
<br />1
<br />Fax:
<br />DESCRIPTION OF REQUEST:
<br />Describe the request in detail (attach additional sheets if necessary):
<br />RECEIVED
<br />JAN 18 2012
<br />CITY OF ORONO
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