Laserfiche WebLink
PC <br /> Exhibit A <br /> City of Orono #17-3979 <br /> Variance Application <br /> Street Address: Application# <br /> "cLO A ' 2750 Kelley Parkway <br /> <�/ Orono,MN 55356 Date Received: <br /> Main: 952-249-4600 Staff: <br /> fax: 952-249-4616 Fee: $700 <br /> a Mailing Address: <br /> . P.O.Box 66 Escrow: $700 / $2,500 <br /> Crystal Bay,MN 55323-0066 Notes: <br /> -1KESHO <br /> Please complete. Applicant will be notified within 15 days as to the status of the application. <br /> Incomplete <br /> �applications will not be placed on Planning Commission Agenda. <br /> SITE LOCATION: c9 `-t-CD S t k �� U3Cc) 4) 4` <br /> DESCRIPTION OF REQUEST: \Jfc--1 && - C � �— C�P �( � `T-1-1-E_ C-T�- <br /> (atttach additional sheets as necessary) <br /> APPLICANT INFOR ATION: M" heck hertjt Applicant address should be used for billing <br /> Applicant: l it -I--s- <br /> Phone(Primary): (01 a --q 30— 3 0 E <br /> Mailing Address: 9.14a CIO 4% QCity: i CC _ tc J ZIP: <br /> Email: £SGtoT <br /> PROPERTY OWNER INFORMATION: ld'check 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: 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 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 ail. <br /> Applicant Signature: ' . i O b ' Date: 9 - 19 — 17 <br /> • <br /> Applicant Signature: Date: <br /> Property Owner Signature: Date: <br /> Property Owner Signature: Date: <br /> Variance Application—January 2017 <br /> Page 4 <br />