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EXHIBIT A <br /> _ City of Orono <br /> Subdivision Application <br /> Street Address: Application# �J�'Jl��- <br /> ��� 2750 Kelley Parkway Date Received: " � ()5 , <br /> Orono, MN 55356 Amount Paid: � �. im�. +v v�-�,� <br /> � � 0 Staff: J,�-�!I G , _ <br /> ��� Main: 952-249-4600 � a �r �,�j�,� <br /> Fee: <br /> � �' ;�5�• F fax: 952-249-4616 Renewal: •-----�-""` <br /> � �ti Mailing Address: <br /> �9kEsH04'� P.O. Box 66 <br /> Crystal Bay, MN 55323-0066 <br /> This application form must be completed in full. <br /> _ __ . _ <br /> PROPERTY INFORMATION: <br /> Site Address: �l�/ gD �6/ZEST C�4-lCE l__���/,� G <br /> Property Identification Number(PIN): 67 - /t'] � Z�.'� - Z.y -- o��Z- <br /> (Attach legal description to application if not included on the survey.) <br /> Date Property Acquired (month/year): �EB J99z � Abstract or� Torrens, please check one <br /> Present use of property: �Residential ❑ Other <br /> Zoning District: �jZ - �g <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested partY� <br /> Name: �o,QE/J t}/�D .�Ti9�CE� .'SU-FOE/v7�"/7� �/17�4/La2lE"d��) <br /> Phone (home): y�'Z- �c��l� Phone (work): �/Z - 9�/- 9b f�'o <br /> Address: _�y/� 7"//Y���/-Y)rF F�OiI�A- S`St�39 <br /> Email: Go�� � �}-��ET Fax: �/Z ' �77 - .3SSS <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested part ) <br /> Name: La,QE'�J �},J.D '�.T'.9�C�Y �cf-fo��zEiT" �/J',L�F�I�A� <br /> Phone (home): �`� - �y% (�[�,p ' Phone (work): (o/Z - �j'�/- y'��a <br /> Address: (p�/�� Ti/Y���•2 IZl.�E �D/�A- �'1� SS�/3 5' <br /> Email: �,02E--,�J-S C�'_ ,4-Q--, �E-T-- Fax: <br /> EXISTING LAND USE: <br /> Number of Tax Parcels: J <br /> Development Size: Acres Dry Land <br /> Acres Wet Land <br /> Acres TOTAL, all parcels <br /> Present Use (check one) � Residential; Number of Units: <br /> ❑ Other: (Specify) <br /> Present Zoning District LR, - 1 Q <br /> Proposal: <br /> ❑ Division for Tax Purposes <br /> � Lot Line Rearrangement Only (no new building sites) <br /> ❑ Subdivision for New Building Sites <br /> Number of Building Sites Existing Units <br /> New Units <br /> Total Units <br /> Proposed Gross Density Units per Acres <br /> Minimum Lot Size Square Feet Dry Buildable Land <br /> Proposed Use (check) � Residential <br /> ❑ Other(specify) <br /> - 10 - <br /> .,,,� J, � �t ,�'.�;t ;� <br /> � � � „r r.`:'� % '; � .,, � ,� <br /> � '`. � ( �,: . <br /> /`l I.. <br /> E �'I � �I . .. . . �� <br /> . . . . .... _1 <br />