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<br /> � - . Variance Application . � � �� �
<br /> . � Street Address: � Application#p�„-'� 2�S
<br /> ,�`� 2750 KelleyParkway �Date�Received: � 7�/��(UVr
<br /> Y' � Orono, MN 55356 Amount Paid: ���.�a
<br /> . 0 O Sfaff: �U,�,t,a t� 'T�rv�e,�-
<br /> ��. Main: 952-249-4600 Fee: � $600 `
<br /> � � �`� a fax: 952-249-46�6 Renewal: $300
<br /> . '�, . �titi MailingAddress: After-the-fact: $1,200 Double Fee
<br /> �9�ESH�g'� P.O. Box 66
<br /> Crysfal Bay, MN 55323-0066 � .
<br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the
<br /> application. Incomplete applications will not be placed on Planning Commission Agendas.
<br /> PROPERTY INFORMATION: �
<br /> Site Address: 9H�oo ('Jnac.���:�s �o��� Roa�Sl
<br /> Proper�y Identification Number (PIN): � � - ��1 - a� 3�. •, oo a�
<br /> (Attach legal description to application if not included on the survey.) a��-�-.za .
<br /> Date Property Acquired (month/year): ,�,nkM,o�,s-„ ❑ Yes, I own the adjacent parcels.
<br /> Present use of property: C�"Residential � Other � �
<br /> Zoning District: .
<br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party)
<br /> Name: �01'1C�n+ L-0.ri�SC.u.P�n�, .
<br /> Phone (home): q sa �.�a y�i A - Phone (work): � q sa- �f�a - y��8
<br /> Address: ���3 Q�,es�' l...a�n� � Mou�no �53G,�4 �
<br /> Email: a sr� �,-� 3ioz @ rn�r.�.�n��F , ��t Fax: 95�-�t-� a.. - N ��9
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<br /> OWNER INFORMATION: (Complete legal names�ar�d�ri�arital.status required for each interested party)
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<br /> Name: �.a Q�n ����b; .
<br /> Phone (home): ��3 _ �z�- Phone (work):
<br /> Add ress: �H o o (�.no_���,-�t s ���nT 4;o ac�
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<br /> DESCRIPTION OF REQUEST: . Estimated Project Cost: $ acva ,pp
<br /> Describe the request in detail (attach additional sheets if necessary):
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