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City of Orono <br /> Vacation Application <br /> t Street Address: Application# / 7 - d <br /> v 2750 Kelley Parkway Date <br /> Orono, MN 55356 Received: ID 11$10 <br /> Staff: J �j <br /> Main: 952-249-4600 Fee $700.00 <br /> A ' a fax: 952-249-4616 Escrow; $700,00 <br /> 14e. Mailing Address: <br /> 0_' - P.O. Box 66 Notes: Fees assume <br /> 4kES H O Crystal Bay,MN 55323-0066 application not part of <br /> subdivision. <br /> I/We request an Easement or Right of Way on/or adjacent to the following property be vacated: <br /> PROPERTY INFORMATION: <br /> Site Address: Lots 1,2,3 Block 1, CASCO POINT ADDITION - ADDRESSES UNASSIGNED <br /> Submittal Requirements <br /> 0 1 Compteted_VacaOoriAppticatjon -----, <br /> 2 Application fee <br /> 3 . Escrow dolt 91101#17egmerit <br /> O 4 Survey(meeting ALL requirements) Click sere for the City's Survey and Site Plan Requirements. <br /> 5 Data Privacy form <br /> ❑ 6 Hardcover Calculation worksheets. Click aur for the City's Hardcover Information Packet. <br /> 7 ACklitiOnet motion reQ400190 by OitV StOff <br /> 1 8 f Electronic copy of all submitted materials via email, CD or flash drive. <br /> PROPERTY OWNER INFORMATION: (Complete legal names and marital status required for each interested party) <br /> Name: RICK (BARBARA) LUPIENT (AUTHORIZED AGENT: CURT FRETHAM, LAKE WEST DEV, SLC) <br /> Phone(primary): 952-930-3000 (LAKE WEST) <br /> Mailing Address: 14525 HIGHWAY 7, #265 (LAKE WEST) <br /> City,State&ZIP MINNETONKA, MN 55345 (LAKE WEST) <br /> Email: CURT:/LWESTDEV,COM RICKLUPIENTZGMAIL.COM <br /> PROPERTY OWNER: <br /> • Agrees to pay additional fees(staff time not covered in the original fee payment)and/or consultant expenses incurred in review of <br /> this extension application,and <br /> • Certifies that the information supplied is true and correct to the best of hisrher knowledge. The applicant and owner recognize that <br /> they are solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no alternative <br /> but to reject it until it is complete or to recommend the request for denial of the request regardless of its potential merit <br /> • The Property Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property <br /> by City Staff,consultants,agents,Commission and Council Members for purposes of investigation and verification of this request. <br /> • Property Owner acknowledge they must be present at all scheduled review meetings of the City Council. If an applicant and/or <br /> owner is unable to attend a scheduled meeting,please make arrangements to have an authorized representative attend in place of <br /> the applicantiowner and advise the City Planner assigned to your project. <br /> • Information will be distributed via email <br /> Property Owner Signature: Date: 10/17/2017 <br /> Property Owner Signature; (SEE uwNEri AU BOX1 LAS ION) Date: <br /> Vacation Application-January 2017 RECEWED <br /> 1 OCT 1 8 U 17 <br /> # 3989 CITY OF ORONO <br />