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����� <br /> .H` ,' �ity of O ro n o PC Exhibit A <br /> Subdivisto-r� Applica�tion <br /> Street Address: Application# l b-- 3 4� <br /> ��� 2750 Kelley Parkway Date Received: - �/- /D <br /> Orono, MN 55356 Amount Paid: 5 � <br /> � Q Staff: /LI.ZI�Yi� <br /> Main: 952-249-4600 Fee: g ��+D — <br /> � � fax: 952-249-4616 Renewal: <br /> �',�, Gtiti Mailing Address: <br /> �'�kES8o4`'� P.O. Box 66 <br /> Grystal Bay, MN 55323-0066 <br /> This application form must be completed in full. <br /> PROPERTY INFORMATION: <br /> Site Address: //,>'/ Gv�lO.�/�rR rr r-,?A>L <br /> Property Identification Number(PIN): p������ 23 - Z'�-oo y.� <br /> (Attach legal description to application if not included on the survey.) <br /> Date Properiy Acquired (month/year): - �a ❑ Abstract or� Torrens, please check one , <br /> Present use of property: �,(Residential ❑ Other <br /> Zoning District: .0 R- 1 B . . <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: F-.�C= .fR7-/NE�➢L/ <br /> Phone (home): 9S2-2i o -2 6 2 6 Phone (work): S2- y7 6-3�S 9 <br /> Address: �'/o Coco�vE�c B.�NkE� Au,e.✓FT 2oI E �.�k� fr Gv.�Y z��A wr�✓ SS�Si <br /> EmaiL [�,��vc�- /P�iyrarti:�.e.cy car� Fax: y 9s2-y�6 – S`%2l' <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: S7`EUEN 1J .�t�r1 <br /> Phone(home): � Phone (work): <br /> Address: /�3/ �vi�a,vu�e 1"r �,eAic , a�, o.�o�, y�•� ss,��y <br /> Email: Fax: <br /> EXISTING LAND U$E: <br /> Number of Tax Parcels: / . <br /> Development Size: � �9 t Acres Dry Land <br /> o Acres Wet Land <br /> �.89 - Acres TOTAL, all parcels <br /> Present Use (check one) L� Residential; Number of Units: <br /> ❑ Other: (Specify) • <br /> Present Zoning District L�2- 1� <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 /> S New Units <br /> � Total Units <br /> Proposed Gross Density G Units per �89 t Acres ° <br /> Minimum Lot Size S o Square Feet Dry Buildable Land <br /> Proposed Use(eheck). Residential ������� <br /> ❑ Other(s�ecify) <br /> 10 <br /> . JAN 2�1 2010 <br /> CI'�Y OF ORONO <br />