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<br /> Variance Application
<br /> Street Address: Application# ��° '�j
<br /> ,�`�� 2750 Kelley Parkway Date Received: � � "�
<br /> y- Orono, MN 55356 Amount Paid: , dj�.
<br /> � ,� 0 Staff: :��iIOL�
<br /> � Main: 952-249-4600 Fee: 5600
<br /> � ���,� � fax: 952-249-4616 Renewal: $300
<br /> �'.c,�� '�� �ti MailingAddress: . After-the-fact: $1,200 Double Fee
<br /> 9k'ESH�g'� P.O. Box 66
<br /> Crystai Bay, MN 5532?-0066
<br /> This application form must be completed in full. ApF�icant will be notified within 15 days as to the status of the
<br /> _ _ _
<br /> apptication. Incomplete appiications wili not be piaced on Planning Commission Agendas.
<br /> PROPERTY INFORMATION:
<br /> Site Address ��/�� C�l:"�'l� �y f-��1�.�, ��l��l�
<br /> Property Identification Number (PIN):
<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: �Residential ❑ O�her
<br /> Zoning District:
<br /> ��� �/ i�' ...�. ��j� r°�.
<br /> APPLICANT INFORMATION� (Compfete legal:na�:.es and marital status required for each interested party)
<br /> Name: ���'�. f� '�' `�r�=—r-��,���-�.
<br /> Phone (home): ����/ � _ ` - Phone (work):,�G�,S",�_-� �--°.��/
<br /> Address; %S z `/7_=y?�.� , - / '-��-�J� >c��°� �,
<br /> Email: ' '�-`� �'�-�3�a'-'-r'�=� �t=� Fax: ,�� ��c�--iE;� �, - � ii
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<br /> OWNER INFORMATION: (Complete legal names a:�d marital status required for each interested party)
<br /> Name: c�.� . ,., �, � - -�Sc�l`�
<br /> Phone (home): ��5 2- �37-�3/S` Phone (work): L5'�,����� ��'Q �
<br /> Address: /��i"y�c� /`/�ir�r,�c' ��l���t� ,D� �/��it1�ii".�/i.�l�; f��/l1 � s:���5'd�j
<br /> Email: Fax:
<br /> DESCRIPTION 4F REQUEST: � Estimated Project Cost: $
<br /> Describe the request in detail (afitach additional sheets if necessary):
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