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� ' pC Exhibit A <br /> Gity of Orono - <br /> Subdivision Appiication <br /> StreetAddress: Application# —J'�J � <br /> �Q� 2750 Kelley Parkway Date Received: � � <br /> Orono, MN 55356 Amount Paid: <br /> � � � �: <br /> Main: 952-249-4600 Fee: 1 tlD i-'�O p <br /> � � �+ fax: 952-249-4616 � RenewaL• <br /> �, G4i5r Mailirtg Address: <br /> '��o�,� . P.O.Box 66 <br /> Crystal Bay, MN 55323-OQ66 <br /> This appiication form must be completed in full. <br /> PROPERTY INFORMATION: <br /> s�A��: y�o � 5��a ���� c,�-�s-t a � �..� R o�,� �J°� <br /> Property Iderrtification Number(PIN): i( $23 i 3C7�+�� 3e�t !8 Z 3 i 300°L g <br /> . (Atfach legal descrip6on to applicafion if not included on the survey.) <br /> Date Property Acquired(monttUyear): ❑ Abstract or 0 Torrens,please chedc one <br /> Present use of property: ❑Residerrtial �Other �,n�yJS�'f�a � <br /> Zoning District: Itf1c�US�-9�ria.1 <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each irrterested party) <br /> Name: 'pi,v a on C.�i'r1 D o�n i�S U S� 1 r�c-� � CaSW l-�ct►'1 k%��1 S c��n, <br /> Phone(home): Phone(work: (�i 1-y�'{Z- 4$l'1 <br /> Address: �t� �o� 1 O�-h 5�:. 5U�� '?�O� ;�M i n n za(�J�i S� M n� ����3 <br /> Email: C�a Se�J n 'r•Fa n�'•inSc e��?�Z�n C�m oa n i�.�D M Fax: ���Z-�l�'i t-�,Ff►1 <br /> �OYYNER INFORMATION: (Complete legal names and mariial status requir�ed for each infierested party) <br /> Name: �r2. � c.rnc�� n o�c..� � ri 5 �r�n le- <br /> Phone(home): Phone(work): ' ��.- - � <br /> Address: rr,'O Sc+�fi�^ iO-H^ �'�.i Suil-�30C�� M;nnFst O I� S+ Ml� SS4C33 <br /> Email: �ri 5 t bri r�k��'�ixn CJDhn#7c►n i �S��c3� Fax: �p t Z.-c�c� Z. � �Zy t� <br /> DOSTING LAND USE: ' <br /> Number of Tax Parcels: "�- - <br /> Development Size: �,�'l � Acres Dry Lanti <br /> � . j� Acres Wet Land <br /> �"j� q � Acxes TOTAL,atl parcels <br /> Pre.sent Use(check one) ❑ Resider�fial; Number of Un'�ts: <br /> � other.(specify) L r,dJ Stri o. l <br /> Preserrt Zoning District `Y,�J��T�u, ( <br /> Pr+oposat: <br /> 0 Division for Tax Purposes � . <br /> � Lot Line Rearrangement Onfy(no new building sites) " . <br /> 0 Subd'nrision for New Buikling S'rtes <br /> Number of Building Sites � E�dsting Units � <br /> � New Unrts . <br /> � 'Total Un"ds , <br /> Proposed Gross Density Un'�ts per Acres <br /> Minimum Lot Size Square Feet Dry Buitdable Land <br /> Proposed Use(cFieck) 0 Residential <br /> ❑ other(sPeci fi►) <br /> Subd�ivision Apptication Last Updated: Nov+ember2010 ����8 v�� <br /> 10 <br /> t <br /> �uN 2 � 20�� <br /> CITlf OF ORONO <br />