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<br /> PC E.�chibit A
<br /> City of Orono � ,
<br /> Variance Applica#ion � '°
<br /> Street Address: Application# � - " �
<br /> `�' ��� 2750 Kelley Parkway Date Received: Z3 d
<br /> O O Orono,MN 55356 Amount Paid: �• (D � o0
<br /> Staff:
<br /> Main: 952-249-4600 Fee: $600
<br /> � � fax: 952-249-4616 Renewal: $300
<br /> � �,ti`� MailingAddress: After-the-fact: $1,200 Double Fee
<br /> L�kESHO�'� P.O.Box 66
<br /> Crystal 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: � 'U Q a� o i,n� 0 0 VI�U �`1N>
<br /> Property Identification Number (PIN : 7�2,3 - -0 U a
<br /> (Attach legal description to application if not included on the survey.) Lo 2 �/�c j �S c o� -
<br /> Date Property Acquired (month/year): �jc��,, 2�07� Yes, I own the adjacent parcelFr. �/�',�`o ,�,� �
<br /> Present use of property: � Residential ❑ Other ��
<br /> Zoning District: L /d, - / ,�
<br /> APPLICANT INFORMATIOcN� ( omplete legal names and�}arital status re u"ed r each interes pa )
<br /> Name: z l✓, �7T',c e �aV- R�h. L2 �ril[fG /J�uu �ro��S' , . �(�,,ti/�
<br /> Phone (home): q � w ,� Phone (work): y'� - �+')N.,�3,�'
<br /> Complete Addres : (�o rv0 S^
<br /> Email: �; f � Fax: q$2 �f'7S�Z,g
<br /> OWNER INF RMATION' (Co lete legal names and marital status required for each interested party)
<br /> Name: �
<br /> Phone (home): �� ? Phq�e ( ork�: '��-; �-y�- ��' 7
<br /> Complete Address: � ; . �c� �b.r�d�op���s
<br /> Email: ,�j f� Fax: ��� �cf� � 'Z�
<br /> DESCRIPTION OF REQUEST: Estimated Project Cost: $
<br /> Describe the request in detail (attach additional sheet if n c�ssary): �,Q 2 G-ea v e ,.,,% T
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