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�¢F <br />COMMUNITYDEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 790-7005 FAX: (651) 792-7070 <br />(City Code is available on the Internet: www.ci.roseville.mn.us). <br />CONDITIONAL USE PERMIT APPLICATION <br />(CITY CODE CHAPTER 1013) <br />❑ RESIDENTIAL PROPERTY OWNER FEE - $200 <br />❑ BUSINESS/INDUSTRIAL FEE - $550 <br />(All fees payable upon submittal of completed application) <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br />1. Name of Ownef•: <br />��(G � <br />_ <br />2. Address of Owner: <br />��o � S�, � //, <br />3. Name of Applicant: <br />(First) (Middle) <br />I/�� v� T�� <br />(No. And St��eet) <br />(City) <br />�� . !CJ �(' <br />'irst) (Middle) <br />���i iz=L`' �K,�7� �t� <br />4. Add��ess ofApplicant: (No. And Street) (Ciry) <br />a� � i 5�,� i/,.� �%�, �.nl�, <br />5. Street Address of Propert� <br />6. <br />7. <br />o�� � �l� e l� �. <br />Complete Legal Descr <br />Involved: <br />i <br />i� /���G�zC �C� ✓L �i lr <br />(Last) (Phone) <br />�oS�/-��7- �/C�� <br />(State) (Zip) <br />,,, ��, ��,�' ;� �� ii �3 : <br />(Last) (Phone) <br />(State) <br />�:� �, <br />�.S �-�%- `� / �� �) <br />(Zip) <br />,� s���3 <br />i <br />' ��S�i/rL�.E�, ��� � ��� J� �3 <br />on of Property Involved and PID Number (below or attached): <br />�L,���l� ��-�',� S[.=Cc'.a/1� �)�17IL�•� ►��/�Z- � < ��i`CC/ZLllN�r' S <br />� T <br />%�� 7' G 1=� ,� � T � � v T- � �� � j �l � "� � D `{ � 2 7 _ L 3 � I,a'� � <br />State exactly what is intende to be done on or with the property that requires the conditional <br />use permit: <br />t.�-e- �� � -� <br />c � / �� <br />Page 1 of 2 <br />