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��,� <br />��� <br />COMMLINITY DEVELOPMENT 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 Owner <br />2. Address of Owner: <br />=.�".S—v .` <br />3. Name ofApplicant <br />(First) (Middle) <br />� <br />� � �' ����1 (�� ✓ � <br />(No. And Street) (City) <br />� <br />> �i �� ll ; � � � ���-„� <br />(First) � (Middle) <br />S �, � -e <br />4. Address ofApplicant: (No. And Street) (Ciry) <br />(Last) <br />%�s� <br />(State) <br />,�' ��„s-� � � %� , y,�� <br />(Last) <br />(State) <br />(Phone) <br />�.�s � �iy; i <br />(Z1P) <br />_a � J�%3 <br />(Phone) <br />(Zip) <br />S .� �u-� <br />5. Street Address of Properry Involved: <br />-5 �: �-� c <br />6. Complete Legal Description of Properry Involved and PID Number (below or attached): <br />� � <br />{�/�,� � �� Z z�J �<(�-( .�' X F ll 3 r ( v1 �-/ �.-H.,�' �� l' � � r s �3C � 1 <br />1�': Z�, z3, zz . c�c�i� <br />7. State exactly what is intended to be done on or with the property that requires the conditional <br />use permit: / / <br />i� L,/�� c/ �cf l� l-C�' 1 u �� �-%( �i %L' � S, � cl � t4 c`i <<.(� <br />v�� , <br />Page 1 of 2 <br />