Laserfiche WebLink
�if� of Qrona <br /> Ord�n�nce �O,mendment ! �c�ne �hange Appiicafian <br /> ���o ����: ,�p„�ti�,# i� -� <br /> 275d Ke1ey Parkwey <br /> Orono,MN 55358 Date Reaehred: - 'O ` <br /> �c i St6�ii: <br /> Mein: 952,249�600 <br /> fa�c 8E2 248�616 Fee: <br /> ►a ' �Addreas: Escrow#&$ <br /> `�� ,,, „ G�� P.O.sox 86 <br /> ���04� Crystal eay.MN 56s28-oDBe Pennit Fae <br /> NOtes: <br /> Please complete. Applicant will be rn�tif�ed within 15 days as to the status of the application. <br /> Jncvmpletis applications wifl not be placed on Planning Cammisslon Agandas. <br /> SITEl.00A7'ION: �� � S� = N - �'/� a�7'/t�,' '-j - �, <br /> APAI.lCANT/At�EN7 iNFORMATION: <br /> Nams: G a� , ff ' �v5 � <br /> Phona(Primary): ��; _ _ �� <br /> Emar7 Actd�as vsf . • a ; $G„ ..x�,v ' <br /> AAailfsg Address: �-� City: ` N ZIP: � .7�}(} <br /> PROPERIY OWNER INFOR�►TiQM: �daeck here if properiy ovmer is same es applicant <br /> Name: .�,, <br /> Ahone(Primary): <br /> Ema7 Address: 'L.' p,� ��- <br /> Mailing Address: �r��y/ f la.e( l�r• C�Y��,rc��,� 21P: �'�3y� <br /> APPL1CANT/AGEMT ANDIOR OWNER; <br /> • A�ree to pravide aIl infonnation reqnired or roqueated by the Planning peparhnerit, <br /> • Agroe to pay addi�onel fees(staif 4me not covered in 1he origlnal fee paymen�and/flr consulteM eaq�enses incursed in <br /> revlew of thIs appl3c�#ion,and <br /> • Certify that the Ir�fanns6on supplied is true and cortsd to the best of his/her knowledee. The�ppqp�}/��i�pr,pP�� <br /> owner rtcognira thet thoy are salefy respor�ble for submiSlnD a�P�+U��c�lion being awaro fhst upon <br /> tailuro to do so,the a�lf hsw no alOsmativs btrt to reject it uMli It b eompfebe or bo recommend the�+equast for <br /> dsnlal of the�+equest rsgardbss of 11s potentlal marit <br /> • Acknawledge the Eecrow Agneement is oompfet,ed end signed. <br /> � Ths Owner h�eby�owledges and a�rees to this application and further atitlio►izes reasonable entry onb the prnPe�Y <br /> by Ctty Steff,consulta+na,ageMs,Comrrussion and Courxi{Members for purposes cf in <br /> �u� ves'tlgation and veri�icstlQr►of this <br /> + Owr�r andlar applicantlagsnt ockr�owt�dg�tfiey must be prarer�t at all sct�eduled roviowr m,�ettngs of t�e PlQnnfng <br /> Commfsslon and Coanql, tf an appticarrt and/or owner ts unable to atter�d a scheduied meeting, plasss rt�a <br /> arrangements to have an authorized re ive attend fi daae �icant/owner and advise the City Piemer <br /> eseigned to your projact. <br /> ApplicarttlAgerrt Signature: Datt: —l �;��• <br /> Property Ovmer Signature: Date: / l0 �p � <br /> Propetty Owner Signature:`��e9Q'ti �'�'j"'��'� Tr�L N�C,� Rn�oc...�# <br /> Date: <br /> Property C?wner Signature: Da#e: <br /> o�a�anoQ amendmerd�zo►,e Chengs qppl',a�ion— <br /> ��"�"20'f° RECEIVED <br /> Pepv 2 <br /> APR 2 0�,7016 <br /> # 3 8 �g cinr oF oRorvo <br />