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. - � <br /> ` PC Exhibit A <br /> City of Orono � � � <br /> Variance Application . <br /> Streef Address: Application# I Z"35$L <br /> �Q� 2750 Kelley Parkway - Date Received: lp��(p -tZ <br /> Orono, MN 55356 � <br /> 0 � � Staff: (�,�V� <br /> � Main: 952-249-4600 Fee: $700 � <br /> +� � fax: 952-249-4616 Renewal: $350 <br /> �'�,c, Gti`S' MailingAddress: After-the-fact: $1,400 Double Fee <br /> '�.qk.E�og,� P.O. Box 66 . Escrow Fee: $700/ ,50 <br /> Crystal Bay, MN 55323-0066 • <br /> This application form must be completed in full. Applicant will be notified within 15 days as to the status of the <br /> application. Incomplete applications will not be placed on Planning Commission Agendas. <br /> PROPERTY INFORMATION: � � <br /> Site Address: �-l7 ?� / /�O� c5��!' /�i'" <br /> Property Identification Number(PIN): � � <br /> Date Property Acquired (month/year): ❑ Yes, I own the adjacent parcels. <br /> Zoning District: _ �,�/ � � <br /> APPLICANT INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: C'D l5 o h Cv.St-v»�t E-/oM B 5 <br /> Phone (home): Phone (work): �j2_27S'- 8$ 7 1 <br /> Complete Address: / OD/ �/,,� � � <br /> City, State &ZIP rvl;�r���on � �'YI S��'3�'S� <br /> . Email: �o�n,C�/�Golsoh Cr3fo�n Flo�es. C'o� Fax: <br /> -�yr <br /> OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: � � <br /> Phone (home): Phone (work): <br /> Complete Address: � <br /> City, State & ZIP <br /> Email: Fax: <br /> DESCRIPTION'OF REQUES7: . � '",�:' <br /> Describe the request in detail (attach additional sheets if necessary): ��f �;d <br /> , ,, . ����� ' <br /> � �I � 2�1'1 <br /> Variance ApPlication Updated: January 31,2012 li <br /> - 13 - <br />