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-� <br />t� � � <br />���������� <br />COMMUNITY 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 />� BtiSIrvESS/INDtiSTRIAL 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: (First) (Middle) (Last) (Phone) <br />2. <br />Address of Own <br />(No. And Street) U (City) (State) (Zip) <br />3. Name ofApplicant: (First) <br />�- (\ n � <br />4. <br />Address of Applican <br />5. Street Address <br />(Middle) <br />f) (Cl�, <br />1 ��2i� w��1 �(Y���Ja����d� <br />6. Complete Legal Description of Property Involved and PID Number (below or attachedl: <br />F <br />7. � <br />zQ3t4 I <br />_i.. � � r� v • v � r �r ��b--'-! �? I C) r �� — �N � ��G'� ,-'S I � <br />State exactly what is intended to be done on or with the property that requires the conditional <br />use permit: <br />Page 1 of 2 <br />'� I <br />/� <br />