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<br />SEP 15 '9314:25 FAEGRE & BENSON 612 336 3885 <br /> <br />P.2 <br /> <br />CITY or ROSBVIIiLB <br />2"0 CIVXC ~-tD. DRIVE <br />ROSBVIt.LB I JlDf"If.ISOTA 55113 <br /> <br />Please chec:k itsm or itsms for which yau. are applyin;J: <br /> <br />POD $750 <br />== Rezanin; $300 <br />..:::::::.... SI*'~ a 1 U8e P81:mit 8200 <br />_ vacation ot Right-of-tlay. $200 <br />_ Preliminazy ani Final Plat $500 <br /> <br />_ ~..-..ive Plan A:msr4G8nt $750 <br />Divi.aic::ft of Platte:i tat $100 <br />- Jalocaticn of Dwellinq $100 <br />== VIX'iai'Jce to ZCrWrJ 0;rdiMnce $200 <br />_ SbaI:'el.me P8m1t $ 50 <br /> <br />Please cx:aplete toxm by ty:pj.n;J or prirltini in ink. If the spar-- provic1ed are <br />1118uff1ci8nt, U8e d!iUanalllheet8, Jcaym; inf=-tian tD 'the P'-opeI" itsm nurrbers: <br /> <br />1. <br /> <br />'C.c, "",-\-c.h\L 1..:4~t! ~&&cJIt'r::;r~.t' ~~""t ~. ~". Q,,, '-'.....\lm-\. ~12.~ ~oZ.:7 -~ <br />Name of Ownart (F) (MuM1,.) (last) (Phone) <br /> <br />2. <br /> <br />%~. N. c.,~ \;-cri- f\"u.. -sr~~ <br />AddNM ot Owner~ (No. ari! Sl&..et) <br /> <br />~~)~p <br /> <br />-rL <br />(state) <br /> <br />t..l\c" I ( <br />(Zip) <br /> <br />3. <br /> <br /> <br />4. <br /> <br /> <br />~~)~ <br /> <br />T~ <br />(state) <br /> <br />"'~I' <br />(Zip) <br /> <br /> <br /> <br />5.. <br /> <br />6. CCZplet8 x.gal DMcr1ptian of Plaperty Involve:!: ~+ z, 8 \oc:.1c. 7.. ~..~LH!~,.do'e.. <br />C ~~r ~"c..\- ~~'-\o\lW\ J ~fII""!o"" Co~. H,~~ohs. <br /> <br />7. Date Propert.y Ac;uired: . f>~ri-~ UIn~L' ~O~ftjt\- ~ be.. cu.~"t"d a#..- i ~ cf ~~~~ <br /> <br />8. ~ s'8l1t UM of~: ~OV\.. 9. hill/It Zcx1in;J of P.I.~: ~c. <br />P.Lq,c.C Use of P1.~: r~~Q'" ~~ Zcn1n; of Propert.y: $~ <br /> <br />10. Pl.Alent QzprIahsnsive Plan Dllsignaticn: Y\t:Jr ky\l)Iot)\'\ <br />Plq;}Md ~i'V8 Plan o.ignation: '" 0\0 ~"OIPY\ <br /> <br />11. <br /> <br />Mat plan or c:harI;J8 mak8s this nquest nIOWlfuy? <br />sc.. ~ (+b9~"'- 1...",,'1 re-~ <br /> <br />~oJ~ -Go... Va..Llutu. ~ (.~t'.rt <br />- <br /> <br />12. What is the 8i"~ effect of the ~~ c:tanr;e? (For example, an property <br />val1.1eS, health, safety, ~, traffic c:cn:111:1aris, etc.) <br />~:~~~:\;;;::::~ ~~~r;~~~~~ <br />