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PRELIMINARY PLAT APPLICATION <br />CITY CODE SECTION 1102 <br />www.c1.rosev'111e.mn.u.s <br />❑ APPLICATION FEE: $500 <br />❑ ESCROW DEPOSIT: $1,500 <br />Applicationfte and escrow deposit should be made payable to City oJ'Roseville upon submittal cif ompleted application. <br />Escrow funds will be drawn to cover project-related costs. Additionalfimds may be required; surplus funds will be returned. <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />I. Property Owner Information: <br />( <br />, -y <br />..ompany name• <br />Last name: <br />Ed Fo, AM= <br />Phone nu ber: <br />First name: <br />CitylStatelZip: <br />2. Applicant Information: (if 'ifferentfto� bove) <br />( <br />, -y <br />..ompany name: <br />Last name: <br />Phone nu ber: <br />First name: <br />CitylStatelZip: <br />3. Address(es) of Property Involved: (if different from above) <br />4. Zoning Designation: <br />5. Comprehensive Plan Designation: <br />6. Statement of Intent: Describe the properties to be combined or created as a part of this Preliminary <br />Plat application and indicate whether a variance, zoning change, and/or Conditional Use Permit will <br />be required for the proposed parcels or the intended use. <br />Prelin-finary Plat Application Page I of 2 <br />