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, ' PC Exhibit A <br /> City of �rono � � � <br /> . Variance Application <br /> Street Address: Application# �Z ' ��O <br /> . �`�� 2750 Keiley Parkway Date Received: �j '23�lZ <br /> Y Orono, MN 55356 <br /> � � Staff: ('�l ,. <br /> Main: 952-249-4600 � Fee: $700 <br /> � a fax: 952-249-4616 Renewal: $350 <br /> �' �ti�' _ Mailing Address: . . .. ..__ . . . . �After-the-fact:- $1,400 Double Fee . <br /> �l.q�.E�og,� P.O. Box 66 . Escrow Fee: 700 $2,500 <br /> Crystal Bay, MN 55323-0066 <br /> This 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: � � ��5 !Y1�drl�i� �t/� B r��1 a �3']�t/ 553��1': <br /> Property Identification Number (PIN): <br /> Date PrQperty Acquired (month/year): ❑ Yes, I own the adjacent parcels. <br /> Zoning District: : <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: lyJcc/'I< I� lJ ue�Jo w ' <br /> Phone (home): �, - - b � Phone (work): R 5�,- y 7�1-5 9 59 <br /> Complete Address: _j�2� �� ��;c uc <br /> City, State &ZIP Q/��Io �l'1dU �S36y <br /> Email: /Yl��l� 7aoa� �ial,oa,co�r Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: //�9Ja�k � 4r���>> <br /> Phone (home): 65�-2?a_W o7/ Phone (work): R�Z-�7 y-54 S9 <br /> Complete Address: �525 I'1i11;vI�1�� �� <br /> City, State &ZIP pns�►� !�J 5S �u <br /> Email: ��. 70o a� �„.c:ovvt --_ Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional sheets if necessary): T Q��^P c,,�gf,'�A -q 2.H ` <br /> �IGLPi�Grl�r c�h f{IL SGclf� SJC,�c' o� �y A�'op�✓��v �� � Q��.-e���,��� c�l��% �f� a�l�l a /'oa�' <br /> G � . � � f 5 <br /> � te <br /> u �, '»" ff� c�rt ffie Sa • f o t t y4 <br /> 1'n� as �1�� ha�s� �`s na�� �tia�� � •sr�QJl va.� a��� t��s s�t ���,�.��1 y�k�,a fti� /Pas <br /> Gl 'f � 1 -��'o l a v a.fcr� a /`v o '�dc_ a <br /> /`Od� Ct�� c,rfhtr lkL�a,� �e�n1t1 �'�1t bas�m���QMd (,bllhcl�c� 41�n �O��o!✓ 7��1e T��l�/O-7� <br /> �!� Oc15� s <br /> RECF�VED <br /> Variance Application Updated; January'�31,,201z ��, MAY 2 3 2012 <br /> ' ,. � . <br /> � _ � CITY OF ORONO <br />