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<br /> _ City of O ro n o �`g'r A
<br /> Variance Application
<br /> 2750 Ke�ey Pa�rkway ��l'`��;�'�; Date R�ece�e��^ O�
<br /> ��,(�,�.0 --:�.�....
<br /> Orono, MN 55356 Amount Paid: .
<br /> Staff:
<br /> � ��;� Main: 952-249-4600 Fee: S600 •
<br /> ': ;,�. � fax: 952-249-4616 -�,..�Renewal: $30�
<br /> .�, ° • �ti Mailing Address: . After-the-fact: 51,200 Double Fee
<br /> �Rx'Es�I��'� P.O. Bax 66
<br /> Crystal Bay, MN 5532?-0066
<br /> This application forrn must be completed in full. ApF'icant will be notified within i5 days as to the status of the
<br /> application. Incompiete applications witl not be placed on Planning Commission Agendas.
<br /> PROPERTY INFORMATION:
<br /> SiteAddress: � �,� ���,;`;t^: r:��.,�^
<br /> Proper�y Identification Number (PIN):
<br /> (Attach legal description to application if n t iqcluded on the survey.)
<br /> Date Property Acquired ( onthlyear): �_ ❑ Yes, I own the adjacent parce{s.
<br /> Present use of prope�y� �e idential ` ❑ O�her
<br /> Zaning Distric#: � � �
<br /> APPLICANT 1NFORMATION: (Complete iegal na�es and marital status required for each intersted party) ,
<br /> Name: 1`'�� ,� �'+,; �'° r _ - , �.s,�: . .°, Sc,tC-. `=,�;=��� -,�-=�-- — r;� �r' �.. ��: �
<br /> Phone (home): �� �� ��. . '' . - Phone work : ��- � � - _ ,�-
<br /> • . � ) �1 S- � r �• 1 t�
<br /> Address: '�a v,�', �--�j y ) f' i �'�°r!-� �-- t?.�.::� t ,;� 'r_ P Iq'� V` r„ _�
<br /> Email: " Fax:
<br /> OWNER tNFORMATION: (Compfete legal names� �d marital status required for each interestec party}
<br /> Name: ��:.� ` ,:: l-t I�=. :� ��., i' • �+-��� �%�; �_c ci St.�.c� :�� r,•a;�
<br /> Phone (home�, .c,'f �-, � � ` ��r� ; ,'�-` ��,� Phone (work): TMa �::' 1 � �.-� �.� -r �
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<br /> Address: Ra ^�-� �.� ;�..� f� �� � - .,. ,� � ' r� ;,f ,
<br /> c.� `� 1 �; , .� �, i . � r � � C r"" ,+,, ti-�
<br /> Email: Fax:
<br /> DESCRIPTION OF REQUEST: � Estimated Project Cost: $ � S'c��
<br /> Describe the request in detail (aftach additional sheets if necessary):
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<br /> � Jc 1.�� ��n c� �,�n Cr S'-�
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