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RECEIVED <br /> City of Orono OCT 0 7 2016 <br /> Variance Application CmrOFORONO <br /> PC Exhibit A <br /> Street Address; Application 0 /(o — g 7 7 <br /> 1/40:42750 Kalley PartwayO Orono,MN 55355 Date Received: /a- 7--/ 4. <br /> Mein: 952-249.4500 staff <br /> fax 952.249.4818 Fee: �pfl <br /> P.o.sox sosly Esq►#a s `76) <br /> �'I �;' <br /> j <br /> Crystal Bay,MNt 553230008P Fee <br /> Notes <br /> Please complete. Applicant will be notified within 15 days as to the status of the application. <br /> incomplete applications will ad be placed on Planning Co miss1gr Aga a. <br /> SITE LOCATION: 3 ao Co. of- ph,,..o fly.� 30 Payne viewc !024 (7'v y io— 1 /f ov t?aor►, tit. <br /> 2.97e)Prairie to west I a hee.vpt.ti.ll"'. 4:lieett..11,4 A. <br /> DESORPTION OF REQUEST: 4ar#QT (/fin r r a ti ee i ter•i•.'T+r1-�7 tti,a etav/o 10 ee/pI <br /> (attached additional sheets as necessary) c StLt et r A re. (,,Omer, 4R 1' 1 <br /> APPLICANT I AG INFON: use 9 Q c 4 &IA:: 2 4$3, JSP bre cc <br /> Appflcent Name: �-P.s'frry�2 o s( L. C. ori tianic@. <br /> Phone(Primary): <br /> Applicant Email: <br /> Address: City: ZIP: <br /> Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION,,,10 eek here If property owner Is same as applicant <br /> Name: f,Eb Li). 1T,c <br /> Phone(Primary): 'Z 47 3 d 9 U -2 .s?-19 7'7 <br /> Mailing Address: 4`LS A /I1 t. 20!t.to6..St City.Gc ton_a't•t ZIP: SS3`i / <br /> Ems: y �c ie `.), c It hi,'ra . c a� r <br /> J <br /> APPLICANT/AGENTAND/OR OWNER: <br /> • Agree to provide al information required or requested by the Planning Department. <br /> • Agree to <br /> pay additional <br /> teeses(staff lime not covered in the orghfl fee payment)and/or consultant expanses incurred in <br /> revi• Certify that the Information suppled Is true and correct to the best of his/her knowledge. The applicant and owner <br /> recognize that they are solely responsible for submitting a complete application being aware that upon failure to <br /> do so,the staff has no alternative but to eyed It until It Is complete or to recommend the request for denial of the <br /> request regardlsas of its potential merit <br /> • Acknowledge the Escrow Agreement is completed and signed. <br /> • The Owner hereby acknowledges and agrees to this application and further authorizes reasonable entry onto the property <br /> by City Staff.consultants.agents.Commission end Council Members for purposes of investigation and verification of this <br /> request <br /> • 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 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 /> Applicant/AgentSignature: 4]M7 fPa L.C.( Date: aq fA/(lf 4P.at fy`T0r)osA( tai <br /> Applicant/Agent Signature: �%• <br /> . Date: <br /> Property Owner Signature: C��� �� �--, Date: /4�72J4' lots I 8,2 <br /> Property Owner Signature: 8ime,Skftaagos Date: Lot4 <br /> •no•s+metsAm an <br /> Variance Appilcation—may 2016 e Lot 7 <br /> Page <br /> [ tao <br /> aaaax,ssur1ra•r 2 <br /> # 3877 <br />