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PC <br /> Exhibit A <br /> City of Orono #17-3968 <br /> Variance Application <br /> Street Address: Application# 11-- 36i lO b <br /> .O/ft >O 2750 Kelley Parkway kIl <br /> <�/ Orono, MN 55356 Date Received: 0 ^i, _ 1'V 1 � 1 <br /> Main: 952-249-4600 Staff: v lam-'' <br /> fax: 952-249-4616 Fee: $700 (ll � wt Ci ) <br /> � � Mailing Address: <br /> y P.O.Box 66 Escrow: $700 / 500 '/�( I '2? <br /> ee ,#11EL� Crystal Bay,MN 55323-0066 Notes: 1 <br /> ikEsHO-(" <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: 1565 Orchard Beach Place Orono, MN 55364 <br /> DESCRIPTION OF REQUEST: Variance for Lake/Front and Side Yard Setbacks, and Average Setbacks <br /> (attach additional sheets as necessary) <br /> APPLICANT INFORMATION: D check here if Applicant address should be used for billing <br /> Applicant: Sharratt Design 8 Co -Michael Sharratt <br /> Phone (Primary): (952)470-9750 <br /> Mailing Address: 464 2nd Street, Suite 100 City: Excelsior ZIP: 55331 <br /> Email: MSharratt@SharrattDesign.com <br /> PROPERTY OWNER INFORMATION: 0 check here if Property Owner is same as applicant <br /> Ycri(l IA check here if Property Owner address should be used for billing <br /> Name: Fredric& Patricia Johnson <br /> Phone (Primary): (763)780-5000 (Fred) <br /> Mailing Address: 3535 County Rd 44 City: Minnetrista ZIP: 55364 <br /> Email: FredJohnson550/vahoo.com <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 authonzed 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 •-.I. ,,' <br /> Applicant Signature: ii ACA tii r Date: C� /, <br /> Applicant Signature: Date: <br /> ipm ,,� �f <br /> Property Owner Signature: r` ./ Date: c:1,,,, <br /> 7 <br /> f�wa <br /> Property Owner Signature: illiDate: , / •2) <br /> a / 7 <br /> Variance Application—January 2017 <br /> Page 4 <br />