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<br /> . . � . PC Exhibit A �:
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<br /> , C i�ty of O;r�o=n�o .___ _ _ .___ .
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<br /> � Va�riAa n ce .Ap p l�i,cati o n �--. � �
<br /> . .;.: � $treet Address; � `: APPiication# / /-.3 'Jr' �S
<br /> �Q,; 275.0 Kelley Parkway Date�Receivetl: / //
<br /> ��- � �Orono, MN°:55356 ..- .
<br /> �. `... . ,,� , , . , , :. ;. � ;' ` � Staff:
<br /> Main: 952=249=4600 � � Fee. '` :$Z00 �,� f�" ,a7 gS
<br /> �� � � � fax: 952-249-4616 Renewal: :$350 •
<br /> �.� � � Gti`� � ,Mailing Address: : - �,; . After-the-fact: '$1,400 (double fee)
<br /> , _,�v : P.O. Box�66 . , �
<br /> �kEsHO4L . � ,� 'Escr w Fee: .
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<br /> � � ,.Grystal.Ba ,-MN.55323-0066
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<br /> .� . , : � * � . . $2;50O��new home/adtlition/
<br /> Y C'� a7$� -
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<br /> . : , . .,�...new structure �,.
<br /> • -' `.$, 60O,:other variance ,
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<br /> : This application form must be completed in full."Applicant.will be n.otified .within.1'5 days:asto the��status�of the '
<br /> application. -,Incomplete°applications:will��not`b.e:placed on'Planning<C_ornmission:Agendas. � -
<br /> `PROP.ERTY INFORMATION: • w , `
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<br /> Site Adtlress: _.. �Z�i 1: . _� �'� � . . .'
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<br /> Property ldentification'Number.(PIN): ; .=b, �:, p � � � - �
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<br /> ' � , Date Property Acquicetl (montli/yea:r): ., . � ;:'0 Yes,,lrown'the adjacent�parcels. �
<br /> Zoning District: � � "
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<br /> APPLICANT�.INFORMATION: (Com " e�e legal5names�and ma�ital status requi_r.ed foreach.interestetl;party)
<br /> ,Name: ':- . ,. ' , . :
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<br /> Phone (home):-� ' : { ' 'Rhone (wotk) '-�
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<br /> ,•Gomplete:�4ddcess: . � � . /
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<br /> - Cit ; State:& ZIP � ,: � . ._ _
<br /> .Y�...� ;1��}�:,lo .:�C'cL h srdCZ ��:S//� . -
<br /> Email '-t�aCD 'OG� ��0 :�� ;Gln� Fax: :
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<br /> ` �OWNER'INFORMATION: ,(Complete legal inames;antl marital status required°for each interestetl party) :
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<br /> �Name ; '., �.U( � ��P-�' . � fe��d�;cs�i � • .
<br /> ,Phone (home): .,� Rhone (work):
<br /> Complete Address. ' „G:A..(,��' �i_� �
<br /> "City,-State�&.ZIR *� i� , .°M� , -;y• ; . • _
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<br /> EmaiL � � :��AC . La'w� . - , �'Fax: -
<br /> �DESCRIPTION;OF,�REQUEST > � _ , _
<br /> :.Describe:fhe request:in�tletail (attach additional°�sheets ifi necessary); ' . .
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<br /> _ r. a,.�,r:.., . ; . .. � , . .. -
<br /> � � �ECE�v�t�
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<br /> _ . . . ql►G 16:�?.011 ,
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<br /> Lasf Updated:'6/27/201;1
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<br /> .. . Y�v'. r.`y._. � . . . ' .� ' . � " .. .
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