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PC Exhibit A <br /> Cir�r oF �RONo <br /> VARIANCE APPLICATI�N <br /> _ ^� SbeetAddress: Application# r - _ <br /> �J O 2750 Keliey Parkway Date Received_ �� �g° <br /> � <br /> Orono, MN 55356 <br /> Staff: ff�� <br /> Main: 952-249�600 Fee: $700 <br /> 'a � fax' 952-249-46�g Renewal: $350 <br /> ��, ti'� MailingAddress: After-the-fact: $1,400 Double Fee <br /> t G P'�' BOX� Escrow Fee: $700/$2,500 <br /> �xESHo�� Crystal Bay, MN 55323-0066 `�i� <br /> This application form must be compieted in full. Appiicant will be notified within 15 days as to the status of the <br /> application. lncomplete applications wi11 not be placed on Planning Commission Agendas. <br /> PRQPERTY INFORMATION: <br /> Site Address: `j,g-�` fy(,� � <br /> Praperty tdenti�cation Number(PIN}: , -3 <br /> Date Property Acquired (month/year): � Yes, I own the adjacent parceis. <br /> Zoning District: [,,.� � � <br /> APPLICANT IN ORM TIQN: (Complete legal names and maritaf status required for each interested party) <br /> Name: LL� <br /> Phone: Altema#e Phone: <br /> Complete Address: �g-�S ��� �� � � �M�� � � � r M� <br /> Cit�r, State 8�ZfP �; � <br /> Email: ��:q a R Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party} <br /> Name: <br /> Phone Altemate Phone: <br /> Comple#e Address: <br /> City, State 8 ZIP SFP � <br /> EmaiL• F�: <br /> DESCRIPTION OF REQUEST: � <br /> Describe the request in detail (attach additionai sheets if necessary): <br /> � 'z s�?� 6q� s�-� � <br /> �` l `��. +b • t 1.,�r <br /> �- �' :�• c �. �.- � o S t� <br /> V`�.N J ar+� � ( m �J �,c..�-�..�e �-,�, b ► L, t s- <br /> � c�S <br /> + w. <br /> i �� <br /> �� ��� fat�a, c�S-J ee S , <br /> Packe!Last llpdated January 2016 � '•,�„�'� �� �`;~ ,"���. Psge 11 � � 7 � � <br /> �p <br />