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�, �ity at Urono .�, <br /> "- Var�ance Application <br /> � Streef Address: Application# �J�' - 3 �3 9 <br /> ,�`('�� 2750 Keliey Parkway Date Received: ����,.�(1� <br /> Y' Orono, MN 55356 Amount Paid: � � , �a <br /> ��� � Staff: �l/t.�� Ct .�F� <br /> Main: 952-249-4600 <br /> '�.• Fee: $600 <br /> +� ' �'r�:� � fax: 952-249-4616 Renewal: $300 <br /> �'.�, � � '� �ti Mailing Address: , After-the-fact: $1,200 Double Fee <br /> �gkESHOg'�v P.O. Box 66 � . ._ . . ' . __ . .. . <br /> Crystal Bay, MN 5532�-0066 <br /> This application form must be completed in full. ApF:icant wiil be notified within 15 days as to the status of the <br /> � application. Incomplete applications wili not be p(aced on P[anning Commission Ag�ndas. <br /> PROPERTY INFORMATION: <br /> Site Address: � (� (�p� ��e �✓� <br /> Property Identification Number (PIN): �d -//�-a3-�/-(�O� <br /> (Attach legal description to application if not included on the survey.) <br /> Date Property Acquired (m'onth/year): / ❑ Yes, I own the adjacent parcels. <br /> Present use of property: ❑ Residential O�her �� . pp� <br /> Zoning District: <br /> APPLICANT I�NFORMATION: (Complete legal na�:.es anci marital status required for each interested party) <br /> Name: • ��r v-r �%7n�O7�; �6'f� �L--°;.... :__:....,.... _ .. .._.__. ..... �. � . . <br /> Phone (home): � � Phone work):... .9sa-�f�7S- D <br /> Address: , �/ � !y� � <br /> Email: Je�� �`//�5�'�i�Lrnn . ��. Fax: �S�-- `��S=���� <br /> OWNER INFORMATION: (Complete le al�names�.�d marital status required for each interested party) <br /> Name: � // Cj��ZDOG D �lrv /f'1C • <br /> Phone (home): Ph ne (work): �5`0� � ��S= /O <br /> Address: �Z �_ (/j/ <br /> � �" <br /> Email: , Fax: - � =.2 � <br /> DESCRIPTION OF REQUEST: � Estimated Project Cost: $ /(,(, Q -' <br /> Describe the request in detail (attach dditional sheets if necessary): <br /> �(! GZ � �' 1/,� � <br /> •a,yd�.�� .�fl ,�'` �`� ��� <br /> �, � � 6=a��, �? rsur(,k� ;� <br /> �� �•�� �.4� ... / N�� :P . <br /> ��M,r�i� t�.�Eil4:e: 1 <br /> i <br />