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� <br /> REC�`I�ED <br /> AUG T 5 2016 <br /> City of Orono <br /> Conditionai Use Permit Application I� OFORONO <br /> Streer address: ApplicaUon# !�p' �J'� <br /> ��O A lO 2750 Kelley Parkway <br /> ` w Orono,MM 55356 Det@ ReC9ived: �/$- <br /> A Main: 952-249r4800 ��: <br /> tax: 952-249-4616 Fee: <br /> a HlaNing Addrass: EsCrow#8�$ ]O� <br /> y� � � P.O.8ox 86 <br /> C. Crystal Bay,MN 55323-0066 Perrttit Fee <br /> ��'FES H O�� �{p�g: <br /> Please complete. Applicant wi[I be nntified within 15 days as to the status of the application. <br /> Incompiete applications will not be placed on Planning Commission Agendas. <br /> SITE LOCATiON: <br /> APPLICANT/AGENT INFORMATION: <br /> Applicant Nartte: Bobert J Gumnit <br /> Phone(Primary): 6��4r8-A�8 <br /> Appiicant Email: <br /> Address: 1 00 Old Crystal Bay Rd S City:Orono Z�p: 55391 <br /> Agent Name: AgenYs phone number <br /> Agent Emai1: Appllcant is: Contractor Homeowner (Circls One) <br /> PROPER7Y OWNER INFORMATfON: ❑chec�cc here If property owner is same as applicarrt <br /> Name: RohPrt 7 rumnit and Frwnr_ea H Craham <br /> Phone(Primary): 612 7 4 7 0 0 6 S � <br /> Mailing Address: PO Box 85 City:Crystal BAy ZIP: 55323 <br /> Email: �umnir-j @me.com <br /> APPLICANTIAGENT AND/OR OWNER: <br /> • Agree to provide all infoRnation required or reQuested by tha Plannine Departrnent, <br /> • Agree to pay addftional fees(staff time not covered in tha onginal fee peyment) and/or consuftank expenses incutred in <br /> review of this appllcation,and <br /> � Certi(y that the information supplied is true and c�rrect to the best of hisfher knowledge. The appltcant and owner <br /> recogn�e that they are solety responsible for submlttlng e complebe xpplication being aware that upon falture to <br /> do ao,the�taff haa no altemative but to reject it unUl It[s complete or to recommend the request for denial of the <br /> request repardless of its potential merit <br /> • Adcnowledge the�scrow Agreement is completed and signed. <br /> • The Owner hereby acknowledges and agrees to this application and further authonzes reasonable entry onto the property <br /> by City 5taff,CO[13UIf8M.S, agents,C�mmission and Council Members for purposes of inveatigation and verification of this <br /> request. <br /> • Owner andlor Applicant ackrtowkdge they must be present at all scheduled review meetinps of the Planning <br /> Commissior� and Council. If an applicant andlor owner is unabls to attend a scheduled meeting, plaase make <br /> arcangemeMs to have an authorized representative attend in placs of the applicanUowner and advise the City Planner <br /> assigned to your project. <br /> Applicant/Agent Signature: Date: <br /> ApplicanUAgent Signature: ,�Date: <br /> � / l <br /> Property Owner Signature: ' � � / te: � / ( �I �� <br /> Property Owner Signature: ` Y ����" Date: � �f �� /,�� _ <br /> CUP Application-Jartuary 2016 �2 REC E iVE D <br /> AUO 15 2016 <br /> � � V �� CITY OF ORONO <br />