Laserfiche WebLink
PC <br /> Exit A <br /> City ofOrono #17339 0 <br /> Variance Application <br /> Street Aar: Application# / 7-31701 <br /> 2750)(e t Parkuy <br /> rip& <br /> /1. MN Data Received: <br /> > ► faaMen: 116Z1A9at300 Staff: <br /> Adders:�$ Fee: $700 41 --P 4/3iC4p 4- C.C. <br /> ,$ P.O.Box ee Escrow. $700 I $2,500 <br /> tt �,, ` G Crystal Bey,MN 55323.0088 Notes: <br /> 4k 5HO�`� <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: 2-7 0 i t4iPi 1;.S Pp f _ <br /> DESCRIPTION OF REQUEST: 11-4AtirA 54*Ai {rvlp. xadf°aOe 4tt114413 I4 ' <br /> (attach additional sheets as necessary) <br /> APPLICANT INFORMATION: 0 check here If Applicant address should be used for billing <br /> Applicant: 9A Vt j.rsflZas• <br /> Phone(Primary): <br /> Mailing Address: City; ZIP: <br /> Email: <br /> PROPERTY OWNER INFORMATION: 0 check here if Property Owner is same as applicant <br /> 0 check here if Property Owner address should be used for billing <br /> Name: 3.x4. aA". .11 <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 untl 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 en authorized representative attend in place of the applicant/owner and advise the City Planner <br /> assigned to your project. <br /> • information wiH be distributed via <br /> Applicant Signature: Date: <br /> Applicant Signature: Date: <br /> Property Owner Signature: ..0//.: Inlib � Date: <br /> . <br /> Property Owner Signature: . . . J Nwr ll.:. 1 Date: Ce-39- <br /> I---4- <br /> Variance Apptkatrbn-January 2017 <br /> pe d <br /> # 3970 <br />