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I cR11~ CITY OF ROSEVILLE 2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 Please check item or items for which you are applying: {)JiLL- LAn '-?It/ jUJdW p11l V-tJ SI vt- PI j.//j-t.fr1 POD $750 == Rezoning $300 _ Special Use Permit $200 _ Vacation of Right-of-Way $200 _ P.J;eliminary arrl Final Plat $500 _ Cctnprehensive Plan Amerrlment .....x:.... Division of Platted lDt _ Relocation of Dwelling Variance to zoning ordinance - Shoreline Permit $750 $100 $100 $200 $ 50 Please corrplete fom by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keying information to the proper item numbers: 1. 'WE 1)~6ft.S t--ta 1- ( L-L j rhJ CJ raJlJ1tJ_C Af~ Name of owner: (First) (Middle) (last) ()W~&rl,. N()1lI5 ~Ob1t.S;~ C~51#? A-s we- SltflffC. Address of owner: 3. (Phone) (No. and Street) (zip) 'g-/I/I )~one) /?,.lj S-S"7Jtlz (zip) 4. (state) r 'iJ~;;J (Name of Applicant : (First) (Middle) (last) 9g g ~ d~17I btJ b ~T: ~/r&- $HtJ (Address of Appl.) : (No. and street) (City) (state) ;2.t:J9? L G:Jt/AAJ,rL'AJ A-vtF ;U()~ street Address of Property Involved: 5. 6. Complete legal Description of Property Involved: .i-tP"r .:2 g -S,Ltf.? C-A:: -2. r ,eg/l/"c...rp;IV 6' /JatO &7V -p~ A re- At/ 8. ~-I r2-- I c?&..s/#&- )?~& y A-! we; ..[/t;::J?1C "f7)/J/J-4' - t1.Ci!!J.fc..Jt-r; - --gvS'r- 9. Present Zoning of Property: "--e - f I Proposed zoning of Property: 12 - I ' 7. Date Property Acquired: Present Use of Property: Proposed Use of Property: 10. Present Comprehensive Plan Designation: Proposed Comprehensive Plan Designation: 11. What plan or change makes this request necessaIy? 1-19/ ~p,L./r 12. What is the expected effect. of the proposed change? (For exanple, on property values, health, safety, parking, traffic conditions, etc.)