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` 4 <br /> ' PC Exhibit A <br /> � City of Orono <br /> Variance Application - <br /> StreetAddress: Application# �C'( — �j�q� <br /> �Q� 2750 Kelley Parkway � Date Received: Z{r$/O�'( <br /> Orono, MN 55356 <br /> 0 � Staff: <br /> , Main: 952-249-4600 ee: $ d <br /> � �* • fax: 952-249-4616 • <br /> �� '�G~� P.O/Box 66ress: After-the-fact: $1,200 Double Fee <br /> �`�k'ESxa4' Escrow Fee: $600/$2,500 <br /> Crystal Bay, MN 55323-0066 <br /> . This application form must be completed in full. Applicant will be notified within 15 days as to the status of the <br /> application. Incomplete applications will not be placed on Planning Commission Agendas. <br /> PROPERTY INFORMATION: <br /> Site Address: � (o(oQ � �.pq.sa,...�T �� <br /> ProperLy Identification Number(PIN): � � ( —� � t -7 — a:3 —�,3 -- ooaa <br /> Date Property Acquired (month/year): � ❑ Yes, I own the adjacent parcels. <br /> Zoning District: L,(Z— � � <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: �.�j-c(Z �v �A c.c�QS o•� , L/1��E C o�M—►Q.�{ i3v��CJ�e 2S L-r� <br /> Phone (home): ���._9 ��.,,o��,-� Phone (work): 9Sa-�r��l-?�a. 1 <br /> Complete Address: �3 9 a,,..c� ,f-i— � ' <br /> City, State &ZIP C k�z�s , o Q rv� �••, SS 3 3 ( <br /> Email: 4'7c'T�r`S��.r�� c� L.a�kE�d,....,—x.r +3� �a�a.�c ��.Fax: 9.s3-- �,�y.-��r7, <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: ��-,¢�I L�' a- GQ-@ �r F�}A.y t+��sT . <br /> Phone (home): �,5,�..�r-�I— �� Lo Phone (work): Lo l a— 3 87- 3 3 3 Z <br /> Complete Address: �C S��Z��,e�,,,,,_,�s (���(. ' <br /> City, State &ZI P b ,��.� ,�r�ti,_ S 3 3 ( <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional sheets if necessary): �w.�cYZ�S ���,,oz�- <br /> �"'f A-f2� C V u••e2 V�. Awa..o `t� R"�cn 3(`01.. r�_ �r-�P�L� A w.1 1 w�$,���.. <br /> s — �DC.osT.�+, �'S' D 0 s2 sToa' <br /> r���'°�B\1 • <br /> FEB 1 � 2009 <br /> - 14- �I��` OF ORONO <br />