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, PC Exhibit D I <br /> City of Orono � � <br /> Variance Application <br /> Street Address: Application# ��G�_ <br /> �O� 2750 Kelley Parkway Date Received: �-,Z(p1 Z. <br /> Orono, MN 55356 <br /> � � Staff: �� �.�J11� <br /> � Main: 952-249-4600 Fee: $700 <br /> � � fax: 952-249-4616 Renewal: $350 <br /> �'�C, . �ti� ... ._ .Mailing Address: .. . .. After-the-fact:-�-$1,400 Double Fee <br /> '�.�.E�og,� P.O. Box 66 Escrow Fee: $700/$2,50U�N� <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 INFORMA ION: <br /> Site Address: l d�-� �'/��/�!!7 Lf� �D/� � . �� T <br /> Property Identification Number (PIN): d ^ '- .�^� � <br /> Date Property Acquired (month/year): S' ❑ Yes, I own the adjacent parcels. <br /> Zoning District: ��-/A . <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: / o x <br /> Phone (home): �.�`" - 7 "'/ Phone (work): .1" �- P� Y <br /> Complete Address: �� � IV�f dA <br /> City, State & ZIP �fQ�y�,�%A { /'7N S"'S3R / <br /> Email: � F�x�, ,'ZGf/�Y, GO/`7 Fax: <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: � � �,Z�� /Y�' v?� �i�/�S T� L, L G', /=u� S'T,. . <br /> Phone (home): ,2,��j��'4/ - �"Y S" Phone (work): <br /> Complete Address: oZ.p / p011�l T <br /> City, State & ZIP /UAP� �'S �'L <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: � <br /> Describe the request in detail (attach additional sheets if necessary): <br /> � RE�'El��cn � <br /> �� � APR 2 6 2012 - <br /> ' Variance Application Updated: January 31,2012 (,�Ty OF ORONO <br /> • ,1. . <br /> - 13- <br />