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PC Exhibit A <br /> City of Orono � � � <br /> Variance Application <br /> StreetAddress: Application# �Z'�� <br /> �Q� 2750 Kelley Parkway Date Received: •( •I <br /> O O Orono, MN 55356 Staff: ��(,�/� <br /> Main: 952-249-4600 Fee: $700 ✓ <br /> � � fax: 952-249-4616 Renewal: $350 <br /> �'.�C, �ti`�' MailingAddress: After-the-fact: $1,400 ble Fee <br /> l.q�,E�og,� P.O. Box 66 Escrow Fee: $70 $ ,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: .1 <br /> Site Address: � •� y�' (�'�.1`� t�'a^^ �J ��'^I ��' � "` �f3�� <br /> Property Identification Number (PIN): <br /> Date Property Acquired (month/year): �� ❑ Yes, I own the adjacent parcels. <br /> Zoning District: � <br /> APPLICANT INFORMATION: (Com lete legal names and mar,ita status required for each interested party) <br /> Name: �t.L r1 i �F.� �I�� ��� <br /> Phone (home): 9 t 2 • ���- �r-z,� Phon�j(w rk): Cj�'2 y�1 �'�!� <br /> Complete Address: 3�- y l� LU(n.¢--cn fi�x.r. l�N.1� <br /> City, State & ZIP /'l�►.+ S'J� <br /> Email: GL�R C P�? S/ �,Lv�^"�,'c.. Cv� Fax: t. <br /> OWNER INFORMATI : (Complete legal names and marital status required for each interested party) <br /> Name: �4��^-t �- '�'�`� <br /> Phone (home): Phone (work): <br /> Complete Address <br /> City, State &ZIP - � <br /> Email: Fax: <br /> DESCRIPTION OF REQUEST: n <br /> Describe the request in detail (attach additional sheets if necessary): �i�ct�. �,1��-�l �^'�-7` <br /> n <br /> .. ,. <br /> OCT 1'7 2012 <br /> Variance Application Updated: January 31,2012 <br /> �OF ORONO <br /> - 13- <br />