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City of Orono <br />Subdivision Application <br />Street Address: <br />2750 Kelley Parkway <br />Orono , MN 55356 <br />Main : 952-249-4600 <br />fa x: 952-249-4616 <br />Mailing Address: <br />P.O. Bo x 66 <br />Crystal Bay, MN 55323-0066 <br />Applicat ion # 'Z.. q ~ S <br />Date Received=-: ~2.--~~~o-... -e....,.J/...--- <br />Amount ~i ~ '3.S-0 ~ <br />Staff :~ <br />Fee : ::(:'~roe <br />Renewal : <br />This application form niust be completed in full. <br />PROPERTY INFORMATION: <br />Site Address : / :2.o rs r-o L--V\. RO c...J <br />Property Identification Number (PIN): O 3 ~ )( 7 -;23 -/r2-C)OQS <br />(Attach legal description to application if not included on the survey .) <br />Date Property Acquired (month~ear): ____ □ Abstract or tB'Torrens, please check one <br />Present use of property: ~Residential □ Other · <br />Zoning District: (<., (2 -1 Y) ---------------- <br />OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br />Name : <br />Phone (home): Phone (work): ------------Address : <br />Email : Fax : -------------------EXISTING LAND USE: <br />Number of Tax Parcels: <br />Development Size: <br />Present Use (check one) <br />Present Zoning District <br />Proposal: <br />I <br />-~/_,_'-/ __ Acres Dry Land <br />_ __,,{p~--Acres Wet Land <br />--"2.,.__,,.0e.__ __ Acres TOTAL , all parceis <br />[jJ---'" Residential; Number of Units : __j_ <br />□ Other: (Specify) <br />(ZR-:1() <br />□ Division for Tax Purposes <br />□ Lot Line Rearrangement Only (no new building sites) <br />~ Subdivision for New Bu ilding Sites <br />Number of Building Sites --~--Exi sting Units <br />Proposed Gross Density <br />Minimum Lot Size <br />Proposed Use (check) <br />~ New Units <br />7 Total Units <br />d<..~ a---Units per / Acres <br />c Ju s±..Q. ,c-Square Feet Dry Build able Land <br />£?"" Residential <br />□ Other (specify) <br />-10 -1·:9;."''l?t\ ,., i <br />"~~~-...... :,";If" 1 <br />(', __ ,_.p/