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c <br /> PC Exhibit A <br /> City of Orono <br /> , Variance Application <br /> Street Address: Application# � "�2"I <br /> ,�`Q� 2750 Kelley Parkway Date Received: Q-ZZ-Oq <br /> Y Orono, MN 55356 <br /> � � O Staff: I�I.� <br /> Main: 952-249-4600 Fee: $ 0 <br /> � a � fax: 952-249-4616 Renewal: $35 <br /> �� Gti� Mailing Address: After-the-fact: , 00 Double Fee <br /> '�9gESH�4�' P.O. Box 66 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 INFOR ATION: , <br /> Site Address: G � <br /> Property Identification Number(PIN): � -^ � <br /> Date Property Acquired (month/year): ❑ Yes, I own the adjacent parcels. <br /> Zoning District: <br /> APPLICAN NFORMATION: (Compl te legal name nd marit I status require f ach inter ted party) <br /> Name: � <br /> Phone (h e): P one (work)� <br /> Complete ddress: <br /> City, State & ZIP - �. <br /> Email: , Fax: <br /> �3.���s�/ <br /> OWNER INFORM TI (Compl te le�l-�ia s and rital status required for c intereste party) <br /> Name: ��� ,.ui ' � <br /> Phone (home): Pho e (work): � �� <br /> Complete Address: � `� <br /> City, State & ZIP ° <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: , <br /> Describe the request in detail (attach additional sl�eets if necessary): <br /> � <br /> � <br /> � <br /> ' RECEIVE� <br /> - 14- <br /> S E P � � 2009 <br /> CITY OF ORONO <br />