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PC Exhibit A I <br /> City of Orono � <br /> � Variance Application <br /> Street Address: Application# �� -3 7`� <br /> �0� 2750 Kelley Parkway Date Received: i� i� <br /> O O Orono, MN 55356 <br /> staff: M � <br /> Main: 952-249-4600 Fee: $700 <br /> fax: 952-249-4616 Renewal: $350 <br /> �� ��`� Mailing Address: After-the-fact: $1,400 Double Fee <br /> �9kESH0�'� Crystal Bay, MN 55323-0066 Escrow Fee: $600/$2,500 <br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the <br /> application. Incomplete applications will not be placed on Planning Commission Agendas. . <br /> PROPERTY INFORMATION: <br /> � Site Address: 3980 Cherry Avenue � <br /> Property Identification Number(PIN): 08-117-23-33-0026 <br /> Date Property Acquired (month/year): 12 2009 ❑ Yes, I own the adjacent parcels. <br /> Zoning District: ` <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name:. Kevin R. Shultz <br /> Phone (home): 612-710-4656 Phone (work): 952-920-5555 <br /> Complete Address: 5620 Girard Avenue North <br /> City, State &ZIP Brooklyn Center, MN 55430 <br /> Email: kevinrshultz@gmail .com Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: Kevin Ray Shultz & Mandy Rae Shultz <br /> Phone (home): 612-710-4656 Phone (work): 952-920-5555 <br /> Complete Address: 5620 Girard Avenue North <br /> City, State &ZIP Brooklyn Center, MN 55430 <br /> Email: kevinrshultz@gmail .com Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional sheets if necessary): <br /> We wish to build a single family �residence on the vacant land we urchased. <br /> The proposed residence as drawn respects all limitations regardina hard and <br /> structural coverage for the zone it is in as well as prescribed building set <br /> backs from adjacent right of way. <br /> RECEIVED <br /> - 14- <br /> - APR 16 2010 <br /> __ CI71(OF ORONO <br />