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VILLAGE OF ORONO <br />Crystal Bay, Minnesota <br />(Complete in Duplicate) <br />This form to be used in all applications for special use permits and <br />for rezoning, dividing or consolidating parcels of land, vacating <br />streets, alleys and variances. <br />Type of Application _ _ _ <br />Owner of Property: Name <br />Addres s <br />Applicant (other than owner): Name <br />Address <br />Date <br />Phone No. <br />Relationship to <br />Engineer: Name <br />Land Planner: Name <br />Subdivider: Name <br />Phone No. <br />Phone No._ _ _ _ _ _ _ <br />Phone No. <br />Location (How do we find it?) <br />Legal Description: <br />Date Acquired Area (sq.ft.)Single Ownership <br />Separate Ownership <br />Date of last division of this propert <br />Do you own any adjoining property <br />Action Requested ^ <br />Signature of Applicant <br />RECORD OF ACTION TAKEN <br />Date <br />Inspection Deptl: <br />Administrator: <br />Village Council: <br />Village Engineer: <br />Village Attorney: <br />Planning Commission: <br />Village Council: <br />Permit Issued: late <br />~ C ¥ <br />Action <br />£ <br />' ^kjL /vl/? <br />- y- > ‘'f