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<br />J,1Q1 <br /> <br />t <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 applyin1: <br /> <br />HID $750 Carprehensive Plan .Arnerrlment $750 <br />Rezoning $300 - Division of Platted lDt $100 <br />== Special Use Permit $200 == Relocation of DNellin;J $100 <br />.~ Vacation of Right-of-Way $200 _ Variance to Zoni.rq Ordinance $200 <br />~ Preliminary am Final Plat $500 Shoreline Permit $ 50 <br /> <br />Please complete fom by typirxJ or printirxJ in ink. If the spaces provided are <br />insufficient, use additional sheets, keyin;J infonnation to the proper item numbers: <br /> <br />1. A Y1 9 -l--/" i7 ~ e. fZ, C/t /,< Q..; 2 -f?/ ld .R/ h k r ~ h -z..- (~I 'J.J /P '+Lf ';}..~ ? 7 <br />Name of OWner: (First) (Middle) (last) (Phone) <br /> <br />2. 1'16', fal".J/,.fl-W A~e--, nlJ' R~~.e.ullle, 1\1n. ~S-II j <br />Address of OWner: (No. am street) (City)' (state) (Zip) <br /> <br />3. <br /> <br />(Name of Applicant): (First) <br /> <br />(Middle) <br /> <br />(last) <br /> <br />(Phone) <br /> <br />4. <br /> <br />(City) <br /> <br />~ I yo $" <br /> <br />(state) <br /> <br />(Zip) <br /> <br />(Address of Appl.) : (No. am street) <br /> <br />5. R 0 !.e Ill. ,.J VI If t/ e. ~ ..e ~ VI f 7 I. '3 <br />street Address of Involved: <br /> <br />6. Complete Legal Description of Property Involved: P felt 0 3 q K S <br />)I!-I..f,b" ;~ l^':h /}. ~~3~"~ S'~Djl1 1". ~";"'1-C e,,,,1 1,.1 ~i-l.-. <br />A no P/lj e .I ' 0 0' {I P 1. 4- ~ 1 e--:3 0 ~ r. ~ <br /> <br />7. <br /> <br />Date Property Acquired: <br /> <br />Present Use of Property: 'V t1l' U n.. l' <br />Proposed Use of Property: <br /> <br />Q.. \ I <br />9. Present Zoning of Property: i=fJ.. S / all n 1 1" CA.- <br />Proposed Zoning of Property: (2.- \ <br /> <br />-r 0 d i 1/ I d IZ....J Low ~ 1'"( ~ r.iitJJJj. <br />Lr.M) DWS"t: ~D~j(l>L.- <br /> <br />8. <br /> <br />10. <br /> <br />Present Comprehensive Plan Designation: <br />Proposed Comprehe..'1Sive Plan Designation: <br /> <br />11. <br /> <br />What plan or change makes this request necessary? <br /> <br />12. <br /> <br />What is the expected effect of the proposed change? (For exanple, on property <br />values, health, safety, parking, 'b:i1ffi9 rorx.litions, etc.) <br />~!?:>O\U\~l}J \3fL '3 2>'I,.j(~ ~.l'1 <br />