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��� � <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 ❖ Fax: (651) 792-7070 <br />OPEN HOUSE ADDRESS LIST <br />REQUEST FORM <br />This is not a Land Use Application and does not initiate the reviela� timeline mandated in MN Stat. ]5.99. <br />1. Property Owner Information: <br />Company name: <br />Last name: <br />Address: <br />Phone number: <br />First name: <br />City/State/Zip: <br />Email address: <br />2. Applicant Informallon: (if different from above) <br />Company name: <br />Last name: <br />Address: <br />Phone number: <br />First name: <br />City/State/Zip: <br />Email address: <br />3. Address(es) of Property Involved: (if different from above) <br />4. Purpose of Open House: ❑ Comprehensive Land Use Plan Amendment <br />❑ Planned Unit Development/Amendment <br />5. Description of Proposal: <br />❑ Interim Use Permit <br />❑ Rezoning <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 />Signature: Date: <br />