Laserfiche WebLink
City of Orono <br /> Amendment Application PC Exhibit <br /> ❑ Comprehensive Plan I o Ordinance Text / o Zoning Change (check one) <br /> Street Address: Application# /7-3 cf/J <br /> -$.04}� 2750 Kelley Parkway <br /> Orono,MN 55356 Date Received: .1- 2t -/ 7 <br /> -a.. Main: 952-249-4600 Staff' <br /> fax 852-249-4616 Fee: $700 <br /> A I`. ,-1. <br /> Mailing Address: <br /> P.O.Box 66 Escrow: $700 <br /> est` . I.• C' Crystal Bay,MN 55323-0066 Notes <br /> 4krSHOV. <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: 3/-76- Gt)ctyz k blvd OE-0/10 NA 553r <br /> APPLICANT INFORMATION: IWeck here if Applicant address should be used for billing <br /> Applicant: /,kf tuR5 f- U °i,. _. <br /> Phone(Primary): ar _ ,,,— ,err <br /> Mailing Address: f'/, f• r 2 iMillI ' "%& ZIP: <br /> Email: .r ff1,t! ' 'OIL — i_41 i a . ' ,, - f.01 <br /> PROPERTY OWNER INFORMATION: IYck 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: <br /> Email: -------------_.__ ZIP: <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 email <br /> Applicant Signature: Date: 717/90/ 0/0/7; ?,1, /....r. :Th--- <br /> Applicant Signature: Date: <br /> Property Owner Signature: 4"; . Date: ,f4/,-P-6/ if:26)/7 <br /> Property Owner Signature: Date: (' VCELVED <br /> Amendment Application-January 2017 FEB 120 <br /> 17 <br /> Page 4 <br /> 3911 ' CITY OF ORONO <br />