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PC Exhibit A <br /> Ci�r oF ORoNo <br /> VARlANCE APPLICATION <br /> Street Address: Application# Jr-3/~ � <br /> '�,Q�O 2750 Kelley Parkway Date Received: S�d-/S^ <br /> Orono, MN 55356 <br /> Staff: <br /> Main: 952-249�600 Fee: $700 <br /> ,�, �, fax: 952-249-4616 Renewal: $35Q <br /> '��, Gti MailrngAddress: After-the-fact: $1,400 Double Fee <br /> t,� �4�, P.O. 8ox 66 Escrow Fee: $700/$2,500 <br /> x�SK� Crystal Bay, MN 55323-0066 <br /> This application form must be compfeted in full. Applicant will be notified within 15 days as to the status of the <br /> applica�on. Incomplete applicattons will not be placed on Planning Comrnission Agend�s. <br /> PROPERTY INFORMATION: <br /> Site Address: f,2� �- � R+f�R ST , 0�2 0�o , �� ,�39 k <br /> Property Identification Number(PIN): /��/� _ 2 .. _ c�d <br /> Date Property Acquired (monthtyear}: (P ❑ Yes, I own #he adjacent parcels. <br /> Zoning District: �R l � <br /> APPLICANT INFORMATION: {Complete iega! names and marital status�equired far each interested party) <br /> Name: �' �it� .T�.,..L� �N�sZSot� V�kr►�Q�Q.e��' <br /> Phone: �ti �. - ��q _ �4.y.. R+ Alternate one: (�,�� 9�(�, — (a,_,c��. <br /> Complete Address: � ?_a...�- �R��R �T. �tZoN a �lt� �3�' / <br /> City, State 8�ZIP � <br /> Email: ��m . �, � �- 1. Co m Fax: N � #� <br /> OWNER INFORMATION; (Comp e legal names and marital status required for each interested party) <br /> Name: �m�s �, �u��R, <br /> Phone � �- g�9 _ ��-y- Alternate Phone: <br /> Complete Address: a R� �Q, ST' � <br /> City, State &ZIP bN o �� <br /> Email: V�vn - +t��-ct^ � r�e..`�1.v��1.. c a n-. Fax: � <br /> DESCRlPTION OF REQUEST: � <br /> Describe the request in detail (attach additional sheets if necessary): <br /> S tDt 22� S�-'�- <br /> �R--- t��--3� SE� <br /> �Q. �- i i (�e� S��tck..._ <br /> � � T <br /> �o i _ �1t�.�,t's'. <br /> - - - -- ��E� <br /> a <br /> Packst Last Updated.' Januery 2015 f.,:' �-" � � 7 � � C1TY OF ORO NO <br /> ^--- .. <br />