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'.R i <br /> t �-�� '�M y, '°4t,y ��� . <br /> +���. ' >;�S ,tj � <br /> '� + � ` �.,���" PC Exhibit A <br /> r <br /> ,�� ;;��:�. ; <br /> wt <br /> i . s:�Y�' <br /> r i"�;,.'`�sss <br /> F <br /> ���y� ;�� � <br /> C�ty of 4rono <br /> .��� . . <br /> ���:�_�� Subdivision Appf�cation <br /> �� � � Application# //-a�3/ <br /> Street Address: <br /> 0 2750 Ketiey Parkway Date Received: / �i'-// <br /> '� �' Orono, MN 55356 Amount Paid: ,� o'��- � <br /> 0 0 st�tt: .vi� <br /> Main: 952-249-4600 Fee: '� -�D v <br /> � , �, fax: 952-249-4616 Renewal: <br /> ,� G�`�' Marling Address: <br /> ����� Crys a�Bay, MN 55323-0066 <br /> This appiication form must be completed in fult. <br /> PROPERTY INFORMATION: �� � � �2� ��,Gc�Q ���Y+,c� �r✓ Sb^3 S�J <br /> Site Address: � <br /> Property Identification Number(PIN): <br /> (Attach iegal description to appfication if not i�fu �� on the su Abstract or❑ Torrens, please check one <br /> Date Property Acquired (monthlyear): <br /> Present use of properly: 18�Residential ❑ Oth <br /> Zoning District: <br /> APPLICANT INFORMAT.ION: (Complete legal1nra�mes and marital status required for each interested party) <br /> Name: ��� �" � Phone(work): ! a.� ' <br /> Phone(home): � r' <br /> Address: �� �'� a` — <br /> Email: �� C' e.r qr aL;�=�na_. C Ar*� Fax: / /'`�— <br /> OWNER INFOR TION: (Complet legal names�d marital status required for each interested party) <br /> L. S �en s <br /> -Name: . Phone(work): a+� J " <br /> Phone (home): M �, S.. <br /> Address: a� � F�; � <br /> EmaiL <br /> EXISTING LAND USE: �t� V�f,�' , C��' J�'1 �" ���''p� `��Ph e�S�1 <br /> Number of Tax Parcels: Acres Dry Land • <br /> Development Size: ` Acres Wet Land � <br /> � Acres TOTAL, all parceis <br /> Present Use(check one) � Residential; Number of Units: <br /> ❑ Other. (Specify) <br /> Present Zoning District <br /> Proposat: <br /> ❑ Division for Tax Purposes <br /> ❑ Lot Line Rearrangement Only(no new building sites) <br /> � Subdivision for New Building Sites Existing Units <br /> Number of Building Sites New Units <br /> Total Units `D . <br /> Proposed Gross Density a Units per � Acres <br /> Minimum Lot Size Square Feet Dry Buildable Land <br /> Proposed Use(check) Residential <br /> ❑ Other(specify) <br /> Subdivision ApplicaEion Last Updated: November 2010 10 <br /> OCT 19 2011 <br /> � C���JF OFtONO <br />