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<br /> . � ,, ': PC Exhibit A
<br /> � City of Orono . , � -.- ---
<br /> � � Variance Application ' .
<br /> � . �� Street Addr.ess: ;. APpiication# ,�/� �^ 3Y,�(o
<br /> �0� ;: .2750 Kelley ParkwaY ' Date Received:-. •-/� l
<br /> O O Orono;MN 55356 - . ��.
<br /> . Staff ° , �
<br /> � Main; 952-249-4600 - � � Fee $700 .
<br /> "•: fax: 952 249-4616
<br /> �� ' ��ti`� Nlailing Address: , �' Renewal:> $350. .
<br /> , .� , .� After-the-fact � $1;400(double fee)
<br /> P;O. Box 66
<br /> - 9kEsHO4`'� - 4` Escrow Fee , ,` �
<br /> l �Crystal Bay,,�MN 55323-0066 � `.
<br /> , �. ;: • - ' : . - , �, $2,500 new home/addition/ -
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<br /> � . , new structure .
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<br /> '$ 600 other var�ance
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<br /> :° This:application form must be'�completed�m full. Applicant will'be,notified.within 15 days as to the status of the
<br /> ,�; application: Incomplete appl�cations will`.not be placed:on Planning Gommission`Agendas `=
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<br /> �P.ROPERTY INFORMATION: ��g - �
<br /> Site Address. Z1�2: � �.a��r w000l �12 0�dl� .
<br /> � Property,ldentification Number (FIN): . , ,
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<br /> �Date Property Acquired (month/year) • ❑ Yes, I own the ad�acent parcels
<br /> � Zoning District: � � ' �
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<br /> ` APPLICANT INFORMATION�: (Complete'legal names and marital statusrequired for�each interested party)
<br /> Name: �. ��� �11a��� (�o►�.�P s jtic '% 2Ds �-2��j�� �5 -
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<br /> Phone (home): � _ �� Phone (work). 61Z-ZSsf-25�o -
<br /> 'CompleteAddress q/o L���tcw ��� ` .
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<br /> : City, State &'ZIP: :..•�-�;tik.� rh�� 'M�v� .�55} ' /' .
<br /> Email �?'w�G�Prsl��:,lc�e2 Cd . a1.Gc�wt FaX � ' 9sz.=�i7G-' ys� o .;
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<br /> � OWNER INFORMATION �(Complete legal names and marital status required for each interested party)
<br /> Name S%��;c� fQoize °
<br /> Phone (home)•'" - , Phone (work) . �SZ� 35�s=`��d 3
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<br /> ;.Co.mplete Address _�`� �g� S lvr s�-� � f a �r � 5�� • � , .
<br /> � ;City, State & ZIP ,� . �(o�;v�,c���1oa� ; /L�./11 .., ,�5�13 8 : .
<br /> Email � ,.
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<br /> :': . ':'°STz°v�� � t ulDi�[Co, C'o w� ' : -. ., Fax -
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<br /> , ;,;DESCRIPTION OF REQUEST.:- , , , , . . . . . . . .. : .�
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<br /> � Describe the request'in detail .(attach additional sheets if necessary): � . .
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<br /> Last Updated: 5/11/2009 ` " (r � �a�� ,
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