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PC Exhibit A <br /> City of Orono <br /> Variance Application <br /> W31 <br /> \O Street Address: Application* �j 0 Y 0 <br /> 2750 Kelley Parkway <br /> Orono,MN 55356 Date Received. 0 $'/G• <br /> .., Main: 952-249-4600 Staff !_ `� <br /> Fac: 952-249 816 Fee f C V } <br /> .1Healing Address: <br /> Escrow*&$ '�i�C)c ) r <br /> 11,pilloo. <br /> ` P.O.Boz 6s 1el C1_ LF'g5C <br /> G Crystal Bay,MN 55323-0086 Permit Fee /4k9- Notes <br /> Please complete. Applicant will be notified within 15 days as to the status of the application. <br /> incomplete applications will csd be placed on Planning Commission Agendas. <br /> SITE LOCATION: 230 TONKA AVE ORONO MN 55356 <br /> DESCRPTION OF REQUEST: Lot&areaFront setback-30 foot instead of 50 <br /> (attikhed additional sheets as necessary) <br /> APPLICANT/AGENT INFORMATION: <br /> Applicant Name: EVERLAST ENTERPRISES.INC <br /> Phone(Primary): 612-868-0748 <br /> Applicant Email: JinelDEverlastEnterprises.corn <br /> Address: 41Q$NORTH SHORE DRIVE City: MOUND ZIP: 55364 <br /> Applicant is: Contractor Homeowner (Circle One) <br /> PROPERTY OWNER INFORMATION:,PJ'check here if property owner is same as <br /> applicant Name: EVERLAST ENTERPRISES IN <br /> Phone(Primary 612-868-0748 <br /> Mailing Address: 4109 NORTH SHORE DRIVE.ORONO MN ZIP: 55364 <br /> Email: Jim©FverlastEnterprises_corn <br /> APPLICANT/AGENT AND/OR OWNER: <br /> • Agree to provide all information required or requested by the Planning Department <br /> • Agree to pay additional fees (staff time not covered in the original fee payment)and/or consultant expenses incurred in <br /> review of this application,and <br /> • Certify that the information supplied 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 reject it until it is complete or to recommend the request for denial of the <br /> request regardless 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 and 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/Agent Signature: , t a,t4 /7 ()tom Date: 10-11-16 <br /> Applicant/Agent Signature: X1 a .1 , Date: <br /> Property Owner Signature: __S Alma_ Date: <br /> Property Owner Signature: Date: <br /> variance Application—May 2016 RECEIVED <br /> Page 2 <br /> 3880 OCT 182016 <br /> CITY OF ORONO <br />