Laserfiche WebLink
PC <br /> City of Orono Exhibit <br /> #17-3917 <br /> Variance Application <br /> /� 2Street Address:_ Application# <br /> �O` VO Orono,MIN 55356 y Date Received: <br /> Main: 952-249-4600 Staff: <br /> fax: 952-249-4616 Fee: $700 <br /> Mafsng Address: <br /> . P.O.Box 66 Escrow: $700 I $2,500 ' <br /> �` G�ill1C- Crystal Bay.MN 55323-0066 Notes: <br /> EKES H Oi`� <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: 1100 J ,AJo`'11'1 '511Cre. 6114 Vt., (Ye P10, 19 1 ) 56'3( '-I <br /> DESCRIPTION OF REQUEST: f\le, o tl'uc.-ttLY t' bt..c'Id <br /> (attach additional sheets as necessary) <br /> APPLICANT INFORMATION: ¢(check here if Applicant address should be used for billing <br /> Applicant: _.3O 1C'i (ma L/i cavi 5p(i n t+P V" <br /> Phone(Primary): Jame) (6o-1) 301-i,1a4 i ij;c.k.-1 (5o•)) 9et.3' 7'0H <br /> Mailing Address: 501 ."..;0,110 j t t ;U) City: A Li 5 Hsi MN ZIP: 552/a <br /> Email: VC15a(inier ` ai(• Com <br /> PROPERTY OWNER INFORMATION: XLcheck here if Property Owner is same as applicant <br /> ' 0 check here if Property Owner address should be used for billing <br /> Name: <br /> Phone(Primary): <br /> Mailing Address: City: ZIP: <br /> Email: <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 e, ail. <br /> Applicant Signature: 7, _ --:,-Pl` ?..- L. Date: -^/ i'/ <br /> Applicant Signature: - (dL! I . `k Leg Date: -W/677/7 <br /> i <br /> e. <br /> Property Owner Signature: _ -• '' c -1 2y�' Date: /S'�7 <br /> Property Owner Signature: I' f _' f •• t,A 1 Date: L r/// 7 <br /> Variance Application-January 2017 <br /> Page 4 <br />