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C�ty ot orono C�
<br /> +� . Variar��e Applica�ion . � --
<br /> � Streef Address: • Application# ' d��"�/�'S
<br /> ��� 2750 Kelley Parkway Dafe Received: rj/�a���,�.�'p�-, .,.
<br /> Orono, MN 55356 Amount Paid•
<br /> � � � . Staff: ��(�. ��, . • .ifiUl% �
<br /> t. Main: 952-249-4600 Fee; $600 '"�
<br /> +� �' �, •. � fax: 952-249-4616 Renewaf: $300
<br /> �',�,� � , �� Mailing Address: . After-the-fact: $1,200 Double Fee
<br /> `��'Esx�o�"� P.O. Box 66
<br /> Crystal Bay, MN 5532�-0066
<br /> This application form must be completed in full. ApF:icant wili be notified within 15 days as to the status of the
<br /> application. Incomplete applications will nofi be placed on Planning Commission Agendas.
<br /> PROPERTY INFORMATION: , �
<br /> Site Address: ��L�6� �a�r'��1. �>1��1Q�' 'D i21 V2-
<br /> , Property Identification Number (PIN): • �
<br /> (Attacli (egal description to application if not included on the survey.) •
<br /> Date Property Acquired (month/year): �-�i'"/6�� ❑ Yes, I own the adjacent parcels.
<br /> Present use of property: � Residential ❑ O�her
<br /> Zoning District: L:1� ( C�
<br /> 4PPLICANT tNFORMATION: (Complete legal na�:.es and marital status required for each interested party)
<br /> ._Jame: , Gr- ��IJ.Q�l�a�o�.r�
<br /> Phone (home): g S2 _ .y �i � �, 9 z Phone (work): �i z Si� i�3 0 �
<br /> Address: .3 / �..r .�t/„.�-r,�.. `staole t�� 4,��v 7-��� � -���� .
<br /> Email: ._. . � ��A_ .. .,, .Fax:��{': �r�� ,�
<br /> OWNER INFORNIATION: (Complete legal names �:�d marital status required for each interested party)
<br /> Name; �i� �-=ti ,p��.v s � � .,D�-.�ti�.c ,�Yl.��tis��v /1il.Q.p2���
<br /> Phone (home): ,9�-� � �� � 2 ��_ Phone (work): �e �� ,�� �, f .� o �
<br /> Add ress: 3� G s' .�rJ.�.e�r-�w �s/��ig� � � .���g ;� �� �i�1i ��3 yl
<br /> Email: Fax:
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<br /> DESCRIPTldN'�O�"REQUEST: ' Estirnated Rroj.�ct Cost: $ �'p���
<br /> Describe the request in detail (attach adclitional.sheets if necessary): �� T-a �s� .��fs�r���
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