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PC <br /> Exhibit A <br /> #17-3916 <br /> City of Orono <br /> Variance Application <br /> Street Address: Application# <br /> �OArO oyP <br /> — <br /> Orono,MNMN 55356 Date Received <br /> Main: 952-249-4600 Staff <br /> fax: 952-249-4616 Fee $700 ^ <br /> -4 Mailing Address: <br /> P.O.Box 66 Escrow $700 I $2,500 <br /> ycel C. Crystal Bay,MN 55323-0066 Notes <br /> ikt'SHO�� <br /> Please complete. Applicant will be notified within 15 days as to the status of the application. <br /> Incomplete applications will not be placed on Planning Commission Agenda. <br /> SITE LOCATION: iota 11 Oi hc, /7v nwubd.e. <br /> DESCRIPTION OF REQUEST: <br /> (attach additional sheets as necessary) <br /> APPLICANT INFORMATION: 0 check here if Applicant address should be used for billing <br /> Applicant: x414- .LsdIL <br /> Phone(Primary): (0/2.- ,x$'75 <br /> Mailing Address: 7cic, t5 4-t- U,xe.344-act-,s4,041._2120 City:t e4. , ZIP: c c,3q 1 <br /> Email: pc-4 - Q.l,r-,36n.coon <br /> PROPERTY OWNER INFORMATION: 0 check here if Property Owner is same as applicant <br /> . check here if Property Owner address should be used for billing <br /> Name: rrresf StAr-pct. <br /> Phone(Primary): 95&-q 3- 7L4gq <br /> Mailing Address: 3'O Lead Sh w City: Orono ZIP: 55356 <br /> Email: ��r-a -r hw-lati@ U <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 via ' -. <br /> /`r/ c / c /1 <br /> Applicant Signature: Lt Date: <br /> Applicant Signature: Ais Date: <br /> a <br /> Property Owner Signature: „JP Date: 2 0 <br /> Property Owner Signature: Date: .)-/k//q- <br /> Variance Application–January 2017 <br /> Page 4 <br />