Laserfiche WebLink
PC <br /> • Exhibit A <br /> City of Orono 17-3976 <br /> Variance Application <br /> V1/�r Street Address: Application# <br /> 2750 Kelley Par <br /> � <br /> -" rO Orono,MN 5356 tway <br /> Date Received: ` 11 <br /> Main: 951249-4600 Staff: l <br /> + fax: 952-249-4816 <br /> - .. Fee: 42- 15 <br /> .� : Address: <br /> 6Mb <br /> �, i -.- ��" P.O.Boot 66 Escrow: / <br /> 3200 t.4It' ��' Crystal Bay.MN 5323-0088 1 <br /> kFSHOT <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: 7�J,5'"reem '-.4 4 c/A/c' ®IeOj s).--iq/ „r .vw k � <br /> DESCRIPTION OF REQUEST: (/AQiAN�+2Azr c1 4r rev- P1"tP4c, >4bbel j <br /> (attach additional sheets as necessary) <br /> APPLICANT INFORMATION: ❑phack here If Applicant address should be used for billing <br /> Applicant: • Sc.27-1 44 ur,`Q k:,%;vi_Ven) <br /> Phone(Primary): 6/, -f4'- S qv! <br /> Mailing Address: 7075- Fet.tscJfe RDA c,i 1a,,. City: (WOAD, M-J ZIP: c5 3 9 j <br /> Email: /Au 4 s-i_ lit erh_ ,co,-, <br /> PROPERTY OWNER INFORMATION: %check here if Property Owner is same as applicant <br /> check here If Property Owner address should be used for billing <br /> Name: ScoZ7 LA Uri€ / ,t,jfr j <br /> Phone(Primary): 6,la -8(q- s^-1 civ <br /> Mailing Address: 7qS-- = + a/e f2oAJ' Alcw.0 City: v) 4vzIP: SCJ q/ <br /> Email: flvufs1 tlt6Mf.,t). C(,vt <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 ail 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 reprtive attend in place of the applicant/owner and advise the City Planner <br /> assigned to your project. <br /> • Information will be distributed via •U. <br /> Applicant Signature: ll - Date: //y�// <br /> Applicant Signature: ek/ . !c. ;,"t t�✓1A.Ate Date: C1//41/77 <br /> f .i/ RECEIVED <br /> Property Owner Signature: �r Date: - / / <br /> SEP 9 2017 • �/ <br /> Property Owner Signature: ,/ /.c.../11 /� i • bate: 17 <br /> Variance Application-January 20 I <br /> Page 4 CITY OF ORONO 3976 <br />