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EXHIBIT A
<br /> - City of Orono
<br /> Variance Application
<br /> �\\ StreetAddress: Application# L� -• . C����
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<br /> � 2750 Kelley Parkway Date Received: . �,: ��
<br /> �i Y �`�'�� Orono, MN 55356 Amount Paid: y(,%(,-)_ !'n
<br /> � ::. 01 Staff: •.l!�(l,iiC.L:
<br /> �•�,:
<br /> �ai�d";,`.w.,.
<br /> Main: 952-249-4600
<br /> �,�a�,�,`� ._ Fee: $600
<br /> a f��'�•;!��?s;::;;.., �,�1 fax: 952-249-4616 Renewal: $300
<br /> � � �'I'��� � / After-the-fact: $1,200 Double Fee
<br /> � ;s=t� °'ti�.� G4 i Mailin Address:
<br /> ��q��=''`���fi�"\ � �: 5
<br /> ++'�.'1'��:g„�.�% P.O. Box 66
<br /> ��sHO�=�' Crystal Bay, MN 55323-0066
<br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the
<br /> application. Incomplete applications will not be placed on Planning Commission Agendas.
<br /> PROPERTY INFOR��M` ATpION�;, , �
<br /> Site Address: .y-f�1 r;����1�a (,���(������ �.,��r�i@�i9.�
<br /> Property Identification Number (PIN): ' ��-�--���'��rj:;�, -i��;- ��I;II��
<br /> (Attach legal description to application if not included on the survey.)
<br /> Date Property Acquired (month/year): ❑ Yes, I own the adjacent parcels.
<br /> Present use of property: ,I��Residential ❑ Other
<br /> Zoning District:
<br /> APPLICANT IN jORMATION: (Complete legal nam �s and marital status required for each interested party)
<br /> rl 1 ^1 1 M1 � 1+1 1 1�� :)l�r. __. .� is 'n�1 � �.8 t
<br /> Name: '-�'',�4,(,y��:� .�F'�i:��,G�.�i E��a(�r, � ��b Pi��,N�-1�1 ��r�.��,
<br /> Phone (home): � �' Phone(work): 'rt�'������i�� ''=�i� "' � �,j`� �` � ',� 4 I.,,
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<br /> Address: ��'I I;f? �+jYi"��� ���M� ( t�,.i.�: ', n� �� ��� `�51;�i ��-,i.�.�r�;,
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<br /> Email: �ff��'�g-��''���, �t G�,;�7�:�! , �� !, Fax: �;,,n��� �.��8:.�y_�;�.�j�;::��?;,
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<br /> OWNER INF�RMATION: (Complete legal names and marital status required for each interested party)
<br /> 4 'n 1��A , 2����t, t�- �u
<br /> Name: �' i ,���;t �;',..�s� �%.��p �;;�;?1'1•°:��
<br /> Phone (home): � -` � Phone (work): ,;,�'1�. i;�i��� _�;�r�+;;P ��,�� �- ,a; E.;�.. !4`��i-G,bl��:�'.�
<br /> Address: !�-IG'f1 �'�tt`�f';r_I�►4�,- 9 �,;t`',r° ','�IJ.i`�^l,.,r�,, ���� �;;�:.,�:�-���, , , �"
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<br /> DESCRIPTION OF REQUEST: Estimated Project Cost: $
<br /> Describe the reque�t in detail.�attach additional sheets if necessary):
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