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1 l <br /> PC Exhibit A <br /> . City of Orono <br /> �� <br /> Subdivision Application <br /> StreetAddress: Application# �7 � 3�j'3 <br /> �Q� 2750 Kelley Parkway Date Received: �D � <br /> O O Orono, MN 55356 Amount Paid: -� Z 4 <br /> Staff: <br /> Main: 952-249-4600 Fee: <br /> � �+ fax: 952-249-4616 Renewaf: � <br /> ��`� Mailing Address: <br /> �`�kEsHOg'� P.O. Box 66 <br /> • Crystal Bay, MN 55323-0066 <br /> This application form must be completed in fulL <br /> PROPERTY INFORMATION: <br /> Site Address: 029� ��' �lJ� . /L�)yS�/� { (�yv�-i0 �i1itJ �-�'�v�O <br /> Property Identification Number(PIN): � S 11�' �- 3 � /bDO / <br /> (Attach legal description to application if not included on the survey.) <br /> Date Property Acquired (month/ ear): /D �j 3 ❑ Abstract or�Torrens, please check one <br /> Present use of property: �esidential ❑ Other <br /> Zoning District: <br /> APPLICANT�I�CMA�ION: (Complete legal names and antal status required for each interested party) <br /> Name: /� Lt�'G/ /�U7 �" (��U .Yr2 <br /> Phone (home): �p / � - qg�- � g 2-3 Phone (work): /a - �'/- � 3 <br /> Address: S j^ L�G( ,/c�r `v � '" ' ' <br /> Email: SGZ�1 . s G @ ►"� Fax. c - s���� <br /> � gs�a - ��� ��� <br /> � OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: ��7`ji'��G�q.�{,e ��IM . �'—n G . <br /> Phone(home): GjS'd?`=9c.,!(p� �(0 9 a,' Phone (work): �,/�w►�� <br /> Address: ��/ 1=l�./i r>G �'_�6 u G� p��*1T e , ��i i°�l�/�!� /t'l S�3��r <br /> Email: _i�'1�/C.e . S�� c�h � (>l�'G , l� � ax: qS-Z- 9 S�� � ! �� s <br /> EXISTING LAND USE: <br /> Number of Tax Parcels: <br /> Development Size: �?��Z Acres Dry Land , <br /> ' , Acres Wet Land , <br /> Acres TOTAL, all parcels <br /> Present Use (check one) �Residential; Number of Units: 1 <br /> ❑ Other. (Specify) <br /> Present Zoning District (Z �j r"j <br /> Proposal: <br /> ❑ Division for Tax Purposes <br /> ❑ Lot Line Rearrangement Only(no new building sites) <br /> �Subdivision for New Building Sites , <br /> Number of Building Sites � Existing Units <br /> � New Units <br /> � Total Units / <br /> Proposed Gross Density � Units per /�.S Acres <br /> Minimum Lot Size Square Feet Dry Buildable Land <br /> ' � Proposed Use(check) Residential {'f2p <br /> �`-' ❑ Other(specify) <br /> - 10 - <br />