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1�� <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 :• Fax: (651) 792-7070 <br />����(l�i� <br />JAN � � 2010 <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 MN Stat. I5. 99. <br />1. Property Owner Information: <br />Company name: �iNl :� K� s a`� �. %-�,.� 4i'�', ev�, —pcs-�.Zbw�t �,n. Cc,v.�'esv� <br />Last name: �11,b�.cr�,�. First name: �� <br />Address: - �� SO �,a . G o.� ci - C• City/State/ i�o = e�►. � l.l Q, y� � S�� 13 <br />Phone number: 6�'l - 63 � � <<�� Email address: <br />2. Applicant Information: (if different from above) <br />Company name: <br />Last name: �1..��,-�, �,�,�-, First name: n Q., <br />Address: �;t.0 O'�7atc�..��-L ��e_ City/State/ ip: �-�. "��,,,�,(, 41M„L S S� l3 <br />Phone number: e� S l- 6`H �`$ g 3 3 Email addxe��- Cow� <br />3. Address(es) of Property Involved: (if different from above) <br />�, b �/ve` <br />��,6 W. C,o.�.C�• � �oseu�l�l.c. i�,�n S�'�l3 <br />4. Purpose of Open House: ❑ Comprehensive Land Use Plan Map Change <br />❑ Planned Unit Development/Amendment <br />5. Description of Proposal: <br />6. <br />7. <br />'� Interim Use <br />❑ Rezoning <br />C� v„ � t� a 2. S�o� �v c. o St ���..: c,� � v�. <br />�YI Z�C,V� : s� �. s i�',!� ` `� L v� c, l, e S 4,�Q-S - <br />�l Information: Provide a sketch plan or site plan with this request form illustrating the <br />uses and their general placement on the property involved, along with any other <br />►n�that would be seful in the consideration of the project or use being proposed. <br />� � Date: � � � / 6 <br />� <br />