|
{
<br /> o,¢�a�o City of Orono FOR CI'['Y USE ONLY
<br /> P.O.Box 66
<br /> � 2750 Kelley Parkway � �`
<br /> Date Received �_ �a: Time:
<br /> � Crysta]Bay,MN 55323
<br /> ��o$yo� (952)249-4600
<br /> RE UEST FOR PR�P�RTY INFORMATION f,,� � �, �� �` �� �
<br /> �
<br /> Q ��;�,,�. z � � � '�,�
<br /> Internal, City Use Only �
<br /> ` �(�: ,t �`�����
<br /> t �.
<br /> Prop��ty�nforra�atiorn: �
<br /> Type: _���sidential ❑ Commercial
<br /> 3• s ° � f�€ � ,
<br /> Address: ����� G '� ��.,��� �'� �� � �t�,�`` �,�.
<br /> �
<br /> Requestar:
<br /> Name: —z=-�� � '+ ' � ~��� --
<br /> � , `�
<br /> Company(if applicable):
<br /> Address:
<br /> CitY: Zip:
<br /> Home Phone: �''�;� h y�-� F s ,�- �- ,�:..
<br /> Alternate Phone: �- � ` ti % �- � �° �'
<br /> Qaze���ns regarding t�� �.bove�ot�d p�°����y:
<br /> �� �! � �.� �l� r ��.� ��@ �� >�i � ��!� P 4�i ��� E��
<br /> 6 �
<br /> � f'
<br /> 1
<br /> �: ��� tl � �
<br /> � �z.� 9 �� , C.,
<br /> � ,�
<br /> � `� '� �� �` ��" � �'�� �' '- �
<br /> �
<br /> ` ��- "��� �_�\, N���.'. � �-Y�,t F.. ' -
<br /> f � �� r
<br /> '``J
<br /> ca t � F n �
<br /> p'`�`}�,.-,;, (-�_._ a s�'� ! ����•'i� � �� a
<br /> '> E' � E � @���i ��M "� r"`a r� `�' !� � k ti
<br /> S.��..c°`»,..j. � �,� '�i� k � 9r:��S , . � �'`� �-��. � '� �'y {, � p+:i bo f . ' .
<br /> ..f�� �`=,6�� N ��, N��,'" F ..`, F 4��� 4�R Y�. R I Fl�. �� J � ' /� -f`'� �c_..�
<br /> r
<br /> t
<br /> , ` B � � � ���'. ,� �
<br /> ..p, � �� � r� �P+.��� � .�" `" q' � � ��� (, �( ` � '! � �� �
<br /> — e`�✓E'�a ��.�% �°s. 6 �:'�> k :�i: F� �' f ,'�✓"�i ` '���� f '':-y � °.� i..�t%
<br /> � � � � , t I �'�
<br /> �i � 1�.s'`✓�`�s,lti ` ��
<br /> � o�r�
<br /> }
<br /> V:\(Permits)\Request for Property Information Form.doc
<br /> Last Updated: August 28,2007
<br /> ..�__ . , .. : �-_ . . � e ...- . _ ,. . , . _� . . ._. . ._ .� , ...; -
<br /> . ,. �, , ,, ;
<br /> , �
<br /> , _ . .
<br /> . -.3:.. . . .. . . .. �i.��4 ;� .
<br />
|