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City of Orono PC Exhibit <br /> Amendment Application <br /> ❑ Comprehensive Plan />r,,Ordinance Text I ❑ Zoning Change (check one) <br /> Street Address: Application# 7 $ 8 <br /> AO Jfl>© 2750 Kelley Parkway <br /> ( � �l Orono,MN 55356 Date Received 1/ —/�—/7 <br /> s r 1 <br /> ..>.. <br /> Main: 952-249-4600 Staff `�J <br /> --- <br /> fax: 952-249-4616 Fee $700 �� <br /> --1.:e6 <br /> � Mailing Address: <br /> y t P.O.Box 66 Escrow $700 �v 1 <br /> I ::// <br /> Crystef Bay,MN 55323-0086 Notes Q <br /> Please complete. Applicant will be notified within 15 days as to the status of the application. <br /> Incomplete applications will not be placed on Planning Commission Agendas. <br /> SITE LOCATION: 2060 Wayzata Blvd.,Orono,MN 55356 <br /> APPLICANT INFORMATION: X check here if Applicant address should be used for billing <br /> Applicant: Dale Richardson <br /> Phone(Primary): 612-708-6085 <br /> Mailing Address: P.O.Box 575 City: Long Lake ZIP: 55356 <br /> Email: CommercialBuildinaServltlive.corn <br /> PROPERTY OWNER INFORMATION: 0 check here if Property Owner Is same as applicant <br /> in check here if Property Owner address should be used for billing <br /> Name: CBS-MN Properties <br /> Phone(Primary): _612-708-6085 <br /> Mailing Address: P.O.Box 575 City: Long Lake ZIP: MN <br /> Email: CommercialBuildingServaillive.corn <br /> APPLICANT AND/OR PROPERTY OWNER: <br /> • Certify that the information supplied is true and correct to the best of his/her knowledge. The applicant and property owner <br /> recognize that they are solely responsible for submitting a complete application being aware that upon failure to do so,the <br /> staff has no alternative but to reject it until it is complete or to recommend the request for denial of the request regardless <br /> of its potential merit. <br /> • The Property Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the <br /> property by City Staff,consultants,agents,Commission and Council Members for purposes of investigation and verification <br /> of this request. <br /> • Property Owner and/or Applicant acknowledge they must be present at all scheduled review meetings of the Planning <br /> Commission and Council. If an applicant and/or property owner is unable to attend a scheduled meeting, please make <br /> arrangements to have an authorized representative attend in place of the applicant/owner and advise the City Planner <br /> assigned to your project. <br /> • Information will be distributed email <br /> Applicant Si (__. � / Z---- — G <br /> PA Signature: 1 Date: 47 <br /> Applicant Signature: ,.---- -) Date: <br /> Property Owner Signature: -f`';‘ Date: /--- /? —/? <br /> Property Owner Signature: Date: <br /> RECEIVED <br /> Amendment Application-January 2017 <br /> Page 4 98JAN 1 7 2017 <br /> CITY OF ORONO <br />