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:� <br />1•%� �� <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 ❖ Faac: (651) 792-7070 <br />� <br />OPEN HOUSE ADDRESS LIST <br />REQUEST FORM <br />This is not a Land Use Application and does not initiate the review timeline mandated in MNStat. 15.99. <br />1. Property Owner Information: <br />� � <br />Comparry name: ,Ci�Z� t � C'/Lz� S � �r�vj � ti � � /�✓, � � <br />� <br />Last name: First name: <br />Address: � �`r� � �� � �� c� ��- N City/State/Zip: � Uf�v°l< < � , � Lz . v' S� l / � <br />Phone number: � S/- � 3/ �/ �' C�' Email address: <br />2. Applicant Information: ('f different from above) <br />Company name: J/l � u/j i c� <br />Last name: ,�r'�-�,c' r�✓r �- v..! First name: /�i9�'�- <br />Address.� �G�� U l� C.-�r . 7��= , fT '�y" m• City/State/Zip: /�'iy,�c.= -�r� v z� 1_`'�� ��`/� j <br />Phone number: ���'i 0-�°% 7�/ Email address: /7gc.� �- C� C's� � S u �✓ %�'¢i�R %.�c; � <br />3. Address(es) of Property Involved: (if d�erent from above) <br />�� zs' �� � ��, �,�. i�,��,� � Ur���� � �� <br />� , <br />4. Purpose of Open House: ❑ Comprehensive Land Use Plan A ent <br />�''Planned Unit Developmentl endmen�+ <br />�t-t , .,� � / / � <br />❑ Interim Use Permit <br />❑ Rezoning <br />5. Description of Proposal: <br />��� c/�% p' 4/✓ U�,� � G J/ z'7v � jti`l U v n� �-t't /� <br />'� � C� Cv�-� . � ..-,� , � .4-T7 � ��1 �' �� ,'�'�zr c�� . ��; � <br />—���� �� <br />6. Additional Information: Provide a sketch plan or site plan with this request form illustrating the <br />intended uses and their general placement on the property involved, along with any other <br />information that would be useful in the consideration of the project or use being proposed. <br />7. <br />%�'L- /-1 �1'X,e'�i✓l,i�+ �/ <br />Date: � � �� � <br />�v <br />��� <br />