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PC Exhibit A
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<br /> , � C�ity�.of Orono .
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<br /> . . +Varian:ce .Ap.pli�clati�on .
<br /> • . ' - . Sfreet Address: � . � ; Application# - —�� �
<br /> , ,�`:0J�,, : ,2750 Kelley Parkway '. Date'Received: �(•�q .p � �
<br /> y:. `V' , �Orono, MN 55356 '
<br /> � . .: ; � , : . '., �s�" Staff � . ` : � . ., � ,
<br /> Mairr: 952-249-4600 . . .'Fee. � � 7
<br /> ` fax: :952=249-461'6
<br /> :Renewal: $350.
<br /> � �� ,, '�,�`� •. Mailing�Address : ,'�' ;,After-the-fact: ., :
<br /> t`�kESHOg'� ,� P O::;Box 66 �: ' _� �Esc �1,400(doubie fee)
<br /> • . :. ' , . . 'Crystai Bay, MN 55323,0066 : ,� � ' .
<br /> :; . : .��,. , $2�5 ew home�addition/ _
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<br /> ; new:structure ' : :
<br /> �$ 600 other variance s �
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<br /> �:' Th'is application.form must be completed in full. �Appli�cant will be:�notified�within 15 days as�to the status�of the;� .
<br /> r"+' application Incomplete applications will not be placed on .Planning�C:ommission'Agendas ,�;;
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<br /> PROPERTY INF.ORMATION:; '' � ' - � �
<br /> Site Add�ress -Z7 D U. JC t vtll�P .t� �%1�. '�J 3�l v
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<br /> P_roperty'Identification Number (PIN) , ' .
<br /> Date'Property Acquired (month/year) �p 0 Yes, I own theaad�acent �arcels
<br /> Zoning 'Q.istrict '�� _ " �°
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<br /> :" APPLICANT INFORMATION: (Complete le�al names°and marital status�required for�each�,interested party)
<br /> . Name " , i�- 'U:t'c� ' a�;-x. ��; -G herar-" "� _ � -
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<br /> " :Phone� home •� .:� . �(22� .Phone (work� . ; ..:�/2- (�7 fl` .y ZZ � �
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<br /> � Complete Address.� •_ 1 �i p IW�I�z�W� .11�`p.� . �, ,,: �..
<br /> a.� City;'°State &.ZIP ; �. �p+z.a,,fl y� '�. � �;
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<br /> ' Email .�� L.�rc., Gl-,�r�d�` � �or .r�fl -,r�,� �Fax .
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<br /> OWNER INFORMATION. (Gomplete legal names and marital status re ired for each�interested party) ; � }�� �
<br /> ��.; Name .�:��t:l�c+r.'p�,��_ ..�--� 'C��e-r��� �°K1����� . .
<br /> ' ��Phone�(home). : ; ::. _ �.:: • . � Phone-(work).
<br /> •Complete`.Address � �
<br /> City,�`State:,&`'ZI P
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<br /> � � ��DESC.RIPTION�,OF`REQUEST :: r,
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<br /> -� Describe ttie.request in detail (attach,additional sheets if necessary): ,� ! ,•
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<br /> Last Updated: 5J11/2009 ..�: , . ,. ....: " . _ . .. • . -°.
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