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<br /> � + r . Variance ,A,pplication . � � ��
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<br /> � � Street Address: Application# � � a- �S
<br /> ' ' ,�` (� �` . 2750 Kelley Parkway �Date�Received: n-o"��-O�
<br /> Y" '�t�� Orono, MN 55356 Amount Paid: ��'jZ} � �rD
<br /> � 0,�� O Main: 952-249-4600 Sfaff: ���� "_��_,_�
<br /> r � ,'., ,��. � Fee: $600
<br /> �;:� fax: 952-249-4616 Renewal: $300
<br /> �� �� �' �ti`� MarlingAddress: After-the-fact: $1,200 Double Fee
<br /> ��'�'ESH�g'� P.O. BoX 66
<br /> Crysfal Bay, MN 55323-0066 � .
<br /> This application form must be completed in full. Applicant wiil be notified wifhin 15 days as to the status of the
<br /> application. Incomplete applications will not be placed on Pianning Commission Agendas.
<br /> PROPERTY INFORMATION: �
<br /> Site Address: J�So C/¢-�22y (���}c,F� , 1�26,t/a `y�t/ S;���,
<br /> Property Identification Number (PIN): �
<br /> (Attach legal description to application if not included on the survey.) . ,
<br /> Date Property Acquired (month/year): a3 zao3 ❑ Yes, I o.wn the adjacent parcels.
<br /> Present use of property: (�Residential ❑ Other � �
<br /> Zoning District: . ..
<br /> APPLICANT INFORMATION: (Complete le al names and marital status required for each interested party)
<br /> Name: p� h'I�-ir.n.✓ �If��gt� �?f rG�fEu�. LY•✓r✓ .�N�4�S�F — �r�c2iEn
<br /> Phone (home): q SZ �7/ 928v � Phone (work): s z 39� ��ICo
<br /> Address: '' L� p2o�a � .�/ SS'36
<br /> � Email: -f-,d��, s�ka,ble� �.r-E-es4v► . �� � Fax: � 95''z 392 (74�0
<br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party)
<br /> N a m e: _o�n �'19�Ti�✓ SG���.B c.� �LI�cl�{�L�� c-Yiv�/ . Sc.;�-�B�€ — �21���
<br /> Phone (home): �Sz �71 fzBY Phone (work): �,�Z 3qz ����
<br /> Address: l SD Cl-f�2/t-% �� �E , rY/�/ S-.�3�0�
<br /> Email: �-6 (c,�., sc�4i bla � a�!-�s4 c� . ��-. Fax: �'SZ 3�z �75� �
<br /> DESCR(PTION OF REQUEST: Estimated Project Cost: $ /So,�oc�
<br /> Describe the request in detail (attach additional sheets if necessary): CR��7� f�p��i�oy�P-�--
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