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<br />Please complete form by typing or printin;J .in ink. If the spaces provided are <br />insufficient, use additional sheets, keyin;; infonnation to the proper item numbers: <br /> <br /> <br />Name of ~UFr~First~B1 (Middle) ~~) <br />14~t7 ~ Nt; ~~~ 1 HIi <br />Address of OWner: (No. am street) (City) (state) <br />M~ ~e?- ~MJ~I ~lic-- <br />(Name of Applicant): (First) (Middle) 1 (last) <br />?1 e-;6 Ho, F'1ft/(Bt<). ~flA..b I HI1 <br />(Address of Appl.) : (No. an:i street) (C1ty, (state) <br />2 7 8tb lV/), fi"1"f?:-VI e:w <br />street Address of Property Involved: <br /> <br />-..a::' <br />~ ~ <br /> <br />CITY OF ROSEVILLE <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br /> <br />Please check item or items for which you are applying: <br /> <br />POD <br />== Rezoning ~ <br />v Spel;;:ial Use Permit <br />== vacation of Right-of-Way <br />_ Pre1i.minary an:i Final Plat <br /> <br />$750 <br />$300 <br />$200 <br />$200 <br />$500 <br /> <br />_ CCirprehensive Plan Amendment <br />Division of Platted IDt <br />- Relocation of INle11in;J <br />== Variance to zoning ordinance <br />Shoreline Pe.nnit <br /> <br />1. <br /> <br />2. <br /> <br />3. <br /> <br />".-' · . , , T <br /> <br />J,f)~'J <br /> <br />$750 <br />$100 <br />$100 <br />$200 <br />$ 50 <br /> <br />~.tJ~>Z? <br />(Phone) <br />!E!5 5/ (}!!;J <br />(Zip) <br /> <br />(Phone) <br /> <br />4. <br /> <br />5. <br /> <br />6. Complete Iega1. Description of Property Involved: ~ B)'.-..A.. <br /> <br />55//"7 <br />(Zip) <br /> <br />7. <br /> <br />Date Property Acquired: <br /> <br />NO\) I qbE? <br /> <br />8. <br /> <br />Present Use of Property: .:I:~M- 9. Present Zoning of Property: <br />Proposed Use of Property: jA Prqx>sed Zoning of Property: <br /> <br />10. <br /> <br />Present Comprehensive Plan Designation: <br />Prqx>sed Camprehensive Plan Designation: <br /> <br />~ <br />II <br /> <br />X"':1- <br /> <br />0.-' <br /> <br />11. What plan or change makes this request necessal.Y? <br />hp.p- ~v-e ~~ <br /> <br />12. What is the expected effect of the proposed change? (For exanple, on property <br />values, health, safei6~ki.n:;J, traffic con::litions, etc.) <br /> <br />.. <br />