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� PC ExhibitA� <br /> Cit� of �rano <br /> Varr'ance A,pplication <br /> str�er,4ddress: A �licatiqn� .`- �. `.. <br /> ��� 27so sc�uey�ray t?�: . ::�`i':.;;; .��� =�,:�". �Q:., _t, _ ::_ . <br /> o ��,MN 55358 _Qa�,�e0elVed:� ;";� �:.� � ��::::::. . =._..:.::. <br /> �Staff.: '� `:_� �: .:i�:�,.;.: „;..:- <br /> Malrc 952-249-460Q --:. .. , � ���;`: `':` . "- � • - <br /> ta�c 952-24g�r181s Fee:. - . �'-j�'Q17. . - - . � ;'+:"��•� . .. - . <br /> � i�" �.0.Booc� �sd'a�±l►.#&�.' • ��' • . � .. . - . ,:i:;;.�'� <br /> �� G� Crystaf 8ey MN 56323-ODB6 PeiTr�it.��� .. '`'': _ . . ._,_ , : .. � <br /> 8@. �' •� •'�s:,i!r;�y.. <br /> ���SHa4� � NOtes::,Y.tti�- . . - • • . , •�.. ,:,,.- . ::.1:;?," <br /> ,,�::�: _ <br /> . � � .. "';'n,;., . <br /> :.��. <br /> P(ease compiste. App#[cant wilf be natffied within '15 days as to the status of the applicatian, <br /> lncomplete app6cations will not be placed on Plar►ning CommEssion Agendas. <br /> 31TE LOCA710N: _�'�C� $rq �.OI.Y� � L,��GO {��tL��j� �� �(� �/(,) <br /> APPUCANT/A(3ENT INFORAAATIO : <br /> Appi'icant Narrte: �lL� <br /> Phone(P�imary}; ft.- <br /> Applicant Errta3l: pr <br /> Address: 15� . C . �"'�O 1� Z1P: 5��}�{' <br /> Applfcant is: Contracfior Homeawner {Circle One) <br /> PROPER'1'Y OWNER INFORMAT!Q N. check here lf property owr�er ts same as aP,�!t�t <br /> r�arne: GA S� �c1�.r�T�F-� c,.�..c.. —�'Bdd Holvt�o,� <br /> Phone(Prn�na�►k (e�Z-QQI _ q�-�7 –' <br /> MaiBng Address: � ' C ZIP: ' . <br /> Email: _ -k9dL1 h(� � mm <br /> -� � _—^� <br /> APPLICANTIAC�ENT AAfD/QR OWNER: <br /> • A�r�ee to pnovfde a�fnfnm�a8at rentafred or reque�tisd by the Planr�n9���, <br /> • AgrBe to pay sddiHonai fess (staf�tlme not c�v�ned�n the or�"mef fiae Pal+ment)and/or consutfarrt expenses lncurred � <br /> r8v�w of this epplh�atlon,and <br /> • Cert�fy that the Miormation suppfied is #rue ancf carrect to the best of his/her knowledg�. The appltcant and owner <br /> rect�n�e that they are solefy responsible for su�m(tttng a compte�appl(cadon befreg awara that upon fatlure to <br /> do so,the ateff has no ali�rrtiative buE bo reject it untN(t Is complebe or to ret:omm8nd ths reqttest for denial of ft�e <br /> retNest re9ardkes ot Its pnterttial merit , <br /> • Acicriauvledge tFie Escraw Agreement is caitpfetad and elgned. . <br /> • '17�e Owner hereby ec�movv�edges and ag�eea ta thts applfc�tlon and further aathorlaes reasoneb�entry ontn the propertY <br /> �Y�Y S#aff�cansu�tants.a9ents, Commfsalan and Councll Members for purposes of investlga#ian and veri�c�tton of this <br /> requ�t <br /> • Ow+�er snd/or Appilcant acimowledg� they must be rrt at a13 scheduled review meetirtgs of the Pla�ning <br /> Commtssiod aod Councll. !i an eppllcant and/o r I unable to attend a schecfuled meeti <br /> atrangements bo heve an autho r+eserita a#er�d in p ce of the appflc:anUavmer and advlss thepClty Plenner <br /> assigned to Your Project <br /> Applicant/Agent Sign e: Da#e: ��" � "-�t� <br /> Applicar�#IAgent Signa . Date: <br /> Property Owner Stgnature:�� r --�-j�-�� Date_ �. j 1 Z� Z�.'al <br /> Property Ovrmer Signaiure: p�; <br /> RECEIVED <br /> VeNam:e App/ketion—Jenrrary201B <br /> '��2 � JAN ? 0�2016 <br /> � ~',� � � �� o oNo <br /> C1TY OF R <br />