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� <br /> ����/ t�►� ��'C�►�'1C� <br /> , 4��riar��e �rpp����t��r� <br /> Sii��t Address: Appl�cation# �}�"__,,��"r s`"� <br /> ,�%`v�"'`��•. �750 Kelley Parkw�y Date Recc:ived: r-�'_�-d�'"'-__ <br /> � � ��� Qrono, MN 55358 Amourit P�icl: ��� , ('y�__ <br /> �� ,�. �'�\ St�fti: tlJl.�l.r�.%1.f� _ _� <br /> i ��:��.�.r,. �� Main: 95z-2�y-4GUC Fee: $60b <br /> f� ,''�%, ,,-r �ll fax: 952-249-4616 Renh���al: �3CiU u — <br /> `'�� ` `' 'i�'• +`�%� P✓la%lin Ad�lr�ss: - — <br /> \�s _�� � ��` p,,: 9 AftPi•-the-fact� $1,'1_0�Uouble Fee <br /> ���, �� '� .�w r F'.O. Box fi6 _ �---___..Y <br /> `;��r��a •// <br /> ��--:� Crystat l3ay, Nit�55323-OGfi6 <br /> "I"his application fr�rrn must ne conipieted in fult. Applic�nt will �,e natified within 1 S days �s to :he status uf the <br /> dpp�i�ation. Irrcam}�lete z�p�9ir.�ticsns wiii �not be �lac�d or� Planr�3ng Cart�missiota Ag�ndas. <br /> PROP�ftTY INFO�tMATl�fM: ��N d <br /> Site Add ress:������–�-�i–,�=�–�2�__�'_. ���T`�(� , ►"'��• '����— <br /> Property Identi ir,atinn Nurnber (PW j: �_( i'�• 2'���dC}D� .� <br /> (�attach legal description to application if � inc�ucfed c�n th� surv�y.) <br /> Date Prop�rty Acquired (month/year): ����❑ Yes, I own the adjacent parcels. <br /> Pr�sent use of prap�rt� ❑ Residential ❑ Qther ��� ________ <br /> Zoning Di�trict: LK-._�"_I_�`„�_ <br /> APPL.iGAtdT INFOF'iMATION: (Gompfete legal names and marital staU.is required for each intereste� party) <br /> Nam�: �j��J ..,)��dJ TS U� <br /> PhoriR {hame}: Pho�e (w�rk): ����Z=����Z'�� <br /> Address:�'�o . 3d+a—�_ ��17'l�- ��v Cit��: ���✓_•__ �p '��1 <br /> Ema il: _°'��p_��'�''I'`'�T''s�f --�tt�c r�rr rC-�-Y►'9 _ Fax: �Z . ��?'.3'�..- '73L�'� _, <br /> . tsfm <br /> C2WNER 6NFO�RMATION: (�ornplete legal names and marital slafus required for eacn interested party) <br /> Name: <br /> Phune (honie): �--��-_--- -- Phone (work): _ �— ^__� <br /> Address� – - --- -._...___---- c�ry' ------ �p� _ <br /> Ei7iail: Fax: <br /> �ESCRIF'T10N OF REC2UEST: Estimated Project Cost: $ ____ <br /> �escribe the req�es:in detail (attach additional sheets if necessary): __ ___ _� <br /> �, +�7 �.:::,iei,r', ��jv^��a�� <br /> �� 'F'�;;.�ci;�r � � <br /> � �. ;�� '4..rc��'';;: : <br /> _� ���, �� . <br /> � � , <br />