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; <br /> - PC Exhibit A � <br /> � C i ty of O ro n o <br /> Variance Application dz- �;�-� <br /> , Street Address: Application# <br /> �0� 2750 Kelley Parkway Date Received: 7� �Z <br /> Orono, MN 55356 �� <br /> O O � Staff: � <br /> Main: 952-249-4600 Fee: $700 <br /> � �+ fax: 952-249-4616 Renewal: $350 • <br /> �'�,c, �tic5' MailingAddress: After-the-fact: $1,400 Double Fee <br /> '�9 � . P.O. Box 66 Escrow Fee: $600/$2,500 <br /> kEsHO�' Crystal Bay, MN 55323-0066 <br /> This application form must be compieted in fuil. Applicant will be notified within 15 days as to the status of the <br /> application. Incomplete applications will not be placed on Pianning Comrnission Agendas. , <br /> PROPERTY INFORNI,�TION: <br /> Site Address: N��� $Qaw�l ` QoA� N�2� (���-�SS 1nN�tSS.6NE'�� <br /> Property identification Number(PIN): 3�l ll g Z 3110003 <br /> � Date Property Acquired (monthlyear): L�T �Q Yes, I own the adjacent parcel�: <br /> Zoning District: 1„(�-) }� — �7$�a N, 3lZ�w�+ �� <br /> -,3�/1� $ z3 �l oo�Z <br /> APPLICANT 1NFORMATION: (Complete legal narnes and marital status required for each interested party) <br /> Name: �'a4�a ' t7 4- l'ft�� M z-�td�6 <br /> Phone (home): qsZ . y7L- i�'�'7 Phone (work): L�L- �-5- Z y�� <br /> Complete Address: �go nt 36LvW*1 �olt� <br /> City, State & ZIP �6 �AILE M�1 5 ?SG <br /> Email: T Y�6 �• +J, ue Fax; tZ- G2�/- ZoS� <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: �uA 17 �- �I�toEC3E /V� �l�V�� <br /> Phone (home): ��2=`{��- 11�"7 Phone (work): �Z. - �ZS- Z'�gS <br /> Complete Address '7�� ^1 3Qo�.►N �l� <br /> City, State & ZIP � o LIlrKE M� S C <br /> Email: .��ST�J�� (� unnr� - ��e Fax: /Z. - Z - Zo <br /> DESCRIPTION OF REQUEST: �� �UVI�-�-Y��� a� <br /> Describe the request in detail (attach additional sheets if necessary): � <br /> FtECE11�ED � 1 2G1Z <br /> . -12- <br /> FEB 2 2 2012 CI1Y OF R <br /> C6T1(OF ORONO <br />