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<br /> , �'}" O� O',.O n O PC Exhibit A
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<br /> Variance "Application
<br /> Street Address: � Application# �7 "J�JZ.
<br /> �Q� 2750 Kelley Parkway ; Date Received: •Q
<br /> O O Orono, MN 55356 ;� Amount Paid: �p� � .
<br /> Staff: GT �
<br /> Main: 952-249-4600 � Fee: $600
<br /> fax: 952-249-4616 Renewal: $300
<br /> � ��� ���F Mailing Address: :; � After-the-fact: 1 200 Dou
<br /> �9g��p� P.O. Box 66 $ , ble Fee
<br /> - Crystal Bay, MN 55323-0066 .
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<br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the
<br /> app�ication. Incomplete applications will not be;placed on Planning Commission Agendas. .
<br /> PROPERTY INFORMATION: '�
<br /> Site Address: ( Z �iS L k��-��..✓ /��� �E �;�.,�.�, ,�-,n S53�c
<br /> Property Identification Number (PIN). � b !/ '�Z 3 1 y O o Z y
<br /> (Attach legal description to application if not included on the survey.)
<br /> Date Property Acquired (month/year): .� z�� ❑ Yes, I own the adjacent parcels.
<br /> Present use of property: LL�'aesidential ❑ Other ' ' �
<br /> Zoning District: �� .
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<br /> APPLICANT INFORMATIOfV: (Complete legal names and marital status required for each interested party)
<br /> Name: �,rR �e�1 �� .
<br /> Phone (home). 9S Z 2�� 9 3 3t � Phone (work): �,�`Z �-Z � � d , d
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<br /> . OWNER INFORMATION: (Complete legal names and marital status required for each interested party)
<br /> Name: (C����. ��/� i . .
<br /> Phone (home). q,fz Zk q �+ 3�� � Phone (work): � `�,S�Z Y7i 1 a�o
<br /> Complete Address: �z�{� L, lc..�,,,��,,, ��� �,,,� r�� �� 3a�
<br /> Email: _k��fit, P k.c..��.�6�1 co r►,, � Fax: .
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<br /> DESCRIPTION OF REQUEST: � • �� Estimated Project Cost: $ p �
<br /> Describe the request in detail (attach additional sheets if neces ary);
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