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` • pC Exhibit A <br /> . . City of Oro�no. <br /> . Variance Application <br /> StreetAddress: . Application# ��- J��P <br /> �O� 2750 Kelley,Parkway Date Received: �p-a0-/ d"�- <br /> O O Orono, MN 55356 Staff: �� lc_.. <br /> - Main: 952-249-4600 Fee: $700 - <br /> a � fax: 952-249-4616 Renewal: $350 � <br /> �',�, . Gti`� Mailing Address: After-the-facfi $1,4 le Fee <br /> l.yk.�xo.g,� P.O. Box 66 Escrow Fee: $70 /$2,500 <br /> Crystal Bay, MN 55323-0066 � <br /> .. . , .. . . ,. ,_ . . ..;: ... ., - <br /> l"his.application�form-must be completed in full. �Applicant�will be°notified within 15 days;as to;the status of the <br /> application. Incomplete applications will not be placed on Planning Commission Agendas. � <br /> PROPERTY INFORMATION: � <br /> Site Address: <br /> Property Identification Number(PI : n� � � <br /> Date Property Acquired (month/year): ❑ Yes, I own the adjacent parcels. <br /> Zoning District: " (�.. � � . <br /> APPLICANT INFORMATION: (Complete le al names and marital status required for each interested party) <br /> Name: , DO C/ • <br /> Phone (home): Phone wor ): •• - <br /> Complete Address: L <br /> City, State & ZI P � <br /> Email: Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: <br /> Phone (home : Phone (work): <br /> Complete Address: p <br /> City, State & ZIP � <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: � <br /> Describe the request in detail (attach additional sheets if necessary): <br /> 1 � <br /> „�.:____ �__,:__.:__„_a_._a. ,__..__.,, ��,� JUN 2 0 2012 <br /> �CITY OF ORONO <br />