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PC Exhibit A <br /> Ci�r oF �RONo <br /> VARIAIVCE APPLICATtQN <br /> Street Address: Application# � "�c�`3��� <br /> �.o�0 2750 Kelley Parkway Date Received: q - �Q_�� <br /> Orono, MN 55356 , . <br /> St �..� <br /> Main: 952-249-4600 Fee: $700 '�a <br /> � �, fax: 952-249-4616 ene a: • <br /> �'t �,� P�r goX�j��� After-the-fact: $1 400 Double Fee <br /> 'kF$H��� Crystai Bay, MN 55323-0066 Escrow Fee: $700/ ,500 �� <br /> `��= <br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status o#the <br /> appiication. Incomplete applications will not be placed on Planning Commission Agendas. <br /> PROPERTY INFORMATION: � � <br /> Site Address: <br /> Property ldentification�umber{PIN): _ � _ ' <br /> Date Property Acquired {month/year); Io% ❑ Yes, I own th adjacent parcels. <br /> Zoning District: [�`1C <br /> APPLICANT INFORMATIQN: (Camplete legal names anci marital status required for each irrterested party) <br /> Narne: �vip� C. W►ASoit Qr!� l;sa L. �i�OSd/� - A�irat.� <br /> Phone: j - s"b- Alter ate Phone: - p _p c� <br /> Complete Address: y�o d <br /> City, State &ZIP p,onp N <br /> Email: W� pn q . n�}� Fax: <br /> C>WNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Narne: rNe k� �Ga,n <br /> Phone � Altemate Phone: <br /> Comptete Add�ess: <br /> City, State &ZIP <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional shee#s if necessary): <br /> �'.c.C� 4 G <br /> Packet Lsst Updsted.- Jsnuary 20i5 ' Cl7Y OF 4RON0 <br /> Pe� „ # 3 7 � � <br />