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, PC Exhibit A <br /> . �����L�:r�'� <br /> �IAY � � �OD$ <br /> C i ty of 0 ro n o ClTY O� +�K�+i�a <br /> � Variance Application <br /> StreetAddress: Application# (� '.�j�� <br /> O�Q�O 2750 Kelley Parkway Date Received: <br /> Orono, MN 55356 <br /> Staff: -� <br /> Main: 952-249-4600 Fee: $600 <br /> � � ';;,� � fax: 952-249-4616. Renewal: 250 . <br /> ���� �ti Mailing Address: After-the-fact: $1,20 ble Fee <br /> �kESxo�''� Crystal Bay, MN 55323-0066 Escrow Fee: $6 /$2,500 <br /> This application form must be completed in full. Applicant wiil be notified within 15 days as to the status of the <br /> application. (ncomplete applications will not be placed on Planning Commission Agendas. <br /> PROPERI"Y tNFORMATION: <br /> Site Address: 2(,�Z� G�,Q�.�''�-Go (�o f r•.r�*�' �,,�-p <br /> Property Identification Number(PIN): <br /> Date Property Acquired (month/year): � ❑ Yes, I own the adjacent parcels. <br /> Zoning District: <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) � <br /> Name: D w N�� � .' ��t�o�-�" � �EF�S�l�1`E"7'" � ,/�h► �� <br /> Phone (home): ��� ' ���� 1 Phone (work): q�Z.�-Zo— �f'��U <br /> Complete Address: � �6� Z.W�. S.�— ' <br /> City, State & ZIP � �;LG�t�cG�D,t�- f /k�..,! �5"��� <br /> Email: �/ Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: �-'G/V� ,� �f3=j".i"`-t� �K Li l�f��� <br /> Phone (home): _��'Z .�� — �q-jp Phone (work):"i' bC� �o�--�=Tl�� <br /> Complete Address: ��Z� G�'�'� �INt" 4�J� <br /> City, State &ZIP Dl�y�O , �N . � �' I <br /> EmaiL• ` Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional sheets if necessary): <br /> �U�s�L�'�'-y t t�l�"�s�� -f?> (=.�=r.tn.a�.�' `-f�'`�Ih �����t1'3�t� ��,�-t�r�t�._.� <br /> o� -- f.�x,w f=��-�c�c h�� �:f7/���r� �-Nd �=.�.,�t-,�c-� �t- IN`l-P-�±- .� <br /> I�! -r�n/ /WD�� Gs?�.IFO�Q-N�Lh�� fifDstii.� I�! }70/1•�l� �O , I�N— <br /> i'�� ���.�G 7'f�, �� e N� s t f7� ��--t� 5�-i�+�,.�c� w�f L L F3 r�' <br /> I.w�'t�.r�� �Nr� �-i''� ,z�.v�icovr�t�' O�F �C. 1�-;titN�� f�,�,�.f(�Guv�2 <br /> _ 1/V GC.t� t�� P��'-�1�tr�,r'��E� �=t��t,it �� r�d �tS �� �'r7, '�'c��+. <br /> S I/�I.Z(ZfJ�r N!� I.(�L Y��G�� �O�—�i �L� f Vv ���F�G'(a°'r— O�= -�''�'G�i <br /> (��a Po�� , . . <br /> - 14- <br />