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, • PC Exhibit A <br /> City of Orono <br /> Variance Application <br /> Street Address: Application# � ���25� <br /> ��� 2750 Kelley Parkway Date Received: `��-Z� -�z— <br /> Orono, MN 55356 <br /> 0 0 Staff: �� <br /> Main: 952-249-4600 Fee: $700 <br /> fax: 952-249-4616 Renewal: $350 <br /> ��t �Gti`� Mailing Address: After-the-fact: $1,400 Double Fee <br /> �ES$o�g, P.O. Box 66 Escrow Fee: $700 /$2,500 <br /> Crystal Bay, MN 55323-0066 � <br /> �.... . �. _ _ . . . __._ _.. . _. <br /> This apphcation form must be completed.in full ,Applicant wil{ be notified within,.15 days as to�the status of the <br /> application;. Incomplete applications will not be placed on Planning Commission Agendas. <br /> :��lPROPERTY INFORMATION: c� �R�, <br /> ' Site Address: �6 �� �6yt,Tl� p� � i21�� � <br /> Property Identification Number(PIN): <br /> Date Property Acquired (month/year): Od ❑ Yes, I own the adjacent parcels. <br /> Zoning District: '�(�� '(� , <br /> APPLICANT INFORMATI N: (Complete legal names and marit I status required for each inte ested party} <br /> Name: ln1� 1��2 w�d�v'v��d �t�,.��T't+ <br /> Phone (home): �jS2 —�T 6 -20/! Phone (work): -3 3� 2 <br /> Complete Address: p � - <br /> City, State&ZIP (� (7i'lJ� '�'►�4- <br /> Email: e V�'}- 0 ev- �wL Fax: 6(2 - 3 9'S-5 5�y 9 <br /> �.V�� Y�� ��]�� � r �� <br /> OWNER I FO MATION: Complef�gal �a�m�es a-� n�c maritaYstatus quired�eac�i ihterested party) <br /> Name: J ��" y� <br /> Phone (home): - T � 0 ( Phone (work): 2 - • /v <br /> Complete Address: 2 (, <br /> City, State&ZIP y�b4, � y�.l ,� f � <br /> Email: � (1� , 11�/\ Fax: <br /> DESCRIPTION OF REQUEST: <br /> Describe the request in detail (attach additional sheets if necessary): <br /> L"� l � �l <br /> � r <br /> Variance Application Updated: January 31,2012 <br /> RECGlVED <br /> - �3MAY 2 3 2012 <br /> C9T1(OF ORONO <br /> , <br />