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Kot~ I O=l. FAX 100 <br />PAGE 01 <br />FEB. -19' 04[THU) 19:55 EDINA PAR!(WES.T TEL:591 6382 <br />City of Orono <br />Subdivisio~ Application. <br />Street Address: Application # <br />P. 001 <br />2750 Keiley Parkway <br />Orono, MN 55356 <br />oate Received: _____ _ <br />Amount Paid: ------~ <br />Staff: <br />Merin: 952-249-4600 Fee: <br />fax: 952-249-46'\6 Renewal: <br />Mai! in g Address: -------- <br />P.O. Box68 . .. <br />Crystal Bay, MN 55323 0066 <br />This application form must be complated In full. <br />F'R PERTY INFORMATION; <br />Sit Address: . / 20 (S ro t...-"'- <br />?ro erty Identification N1.1mber (F'IN): Q s 7 Ll 2 -ci2J ~ /J..:-ooa.s: <br />(Att ch legal description to application if not included on the survey,) <br />Da Property Acquired (month{_year): I □ Abstract or IB"'Torrens, please check one <br />Pre ent use of property: ~esidential D Other <br />Zo ing District: _gJ2 -1 0 / <br />I . <br />(Complete legal narne~ and marital status required for each interested party) <br />-r i <br />· OIM Fax: ~='""-""'c..t..L.J.OG.L...~:!=-~,JJ!.2-.._,,_=-'-!-1--- <br />(Complete I gal n.?Jmes n' marital status required for each lriterestad party) <br />Na e: .,G· --5:, , . <br />Ph ne (home): .f?S:J:f{7 'is>;--p~--5'-1 . i:9one (work): <br />Ad ress: laQ ~I.d:1_6~1,,J fD:z/_ <br />E: ail: i · · Fax: <br />EX SflNG LANO USE: , l <br />Nu nber of Tax Parcels: <br />De elopment Size: ; 'f Acres D I Land <br />f.p _ Acres Wet Land <br />_:.2_0 __ Acres Tf T AL, all parcels <br />Pr sent Use (check one) ~ Re~idential: Number of Units: ,1.. <br />D Other: (Speelfyj <br />Pr sent Zoning District RR-.:113 I . I <br />Pr posal: i <br />D Divis!on for Tax Purposes / <br />□ Lot Line Rearrangement Only (no new buildirn/· g sites) <br />Subdivision for New Building Sites <br />N ber of Bullding Sites --~--Existi~g Units <br />Pr posed Gross Density <br />Mi lmum Lot Size <br />Pr posed Use (check) <br />G, New Ulnits <br />7 Total Units <br />~~ a---. Units per L Acres <br />1fPlsf..g.c . Squa~e FeetDry Builci~ble Land <br />Residential . I I !I t.,,), r='1 0,,\ (,qp=«,,\ <br />CJ Other ($pec1fy)1 ,.,,.,r,·:L, ,,,) ./, •·-.... ,-"' ,:>",-,,,,. <br />-l O -1 eott,B If~ ~~;1 q,__dW <br />_J --