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r- d1~\ , CITY OF ROSEVILLE 2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 Please check item or items for which you are applying: PUD $750 - Rezoning $300 - ==z Special Use Ferrnit $200 _ Vacation of Right-of-Way $200 PreliminaI:y ani Final Plat $500 CaTprehensive Plan Amendment - Division of Platted lot - Relocation of !:Welling - Variance to zonin;J ordinance - Shoreline Pe.tmit $750 $100 $100 $200 $ 50 Please complete form by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keyirq information to the proper item numbers: 1. NOR'rll IIE/GIIT5 LU.TII JER AN ClluRC/1 &:IcJ.~3/f~OI/9 Name of CMner: (First) (Middle) (last) (Phone) 2. tl?tJ/ RICE "5T RIJS&Vlt.I-IE:. M A/ S:~-113 Address of CMner: (No. arrl street) (City) - (State) (Zip) 3. (last) (Phone) 4. (City) (State) (zip) (Address of @pl.) : (No. arrl street) 5. ~ '7 tJ/ ~ lC,s ~-r Street Address of Property Involved.: 6. Complete legal ~iption of Property Involved: S~ I '77JWN 99 N~.I!_ :2.'3 S J/) Al!RB-os af' II Y"" r.t'P <;: 11 $.Q..C.. I r.(tl ~ r ~1i/ J3 7. IXtte Property Acquired: /91/ 8. Present Use of Property: fJHultcl/Rcfl. 9. Present Zoning of Property: -..R Proposed Use of Property: ShM. S Proposed Zoning of Property: R. 10. Present Comprehensive Plan Designation: Proposed Comprehensive Plan Designation: 11. What plan or dlange makes this request necessary? 7e.M rJ~n~"'tl7 NttJDI4LI'r( QPrll!.G 'S"J).4cli , , 12. What is the expected effect of the proposed change? (For exanple, on property values, health, safety, parking, traffic corxtitiO!l8, etc.) ------0 ~ir~~' :5~};~t:::Z)A!:::o <y;