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<br />Please corrplete fonn by typi.rg or printi.rg in ink. If the spaces provided are <br />irisufficient, use additional sheets, keying infonnation to the proper item numbers: <br />1. /)j J.s k eoWt-/J w./e) <br />Name of OWner: (First) (Middle) <br />82DJ )Jor rN\~ 6(~ .fit ltJJ <br />(No. arrl street) (City) <br />D (}J..J((}..... <br />(Name of Applicant): (First) (Middle) <br />l~"'3a &~W S+. SflfUJ- <br />(Address of Appl.) : (No. arrl stree (City) <br /> <br />LAvA ~>>~5 165Y [,Jl C. ~ ~ (bL <br />street Address of Property Involved: <br /> <br />(last) <br />yY1,(L m.v $'IT? <br />(state) (Zip) <br />01'eS~ <br />(last) <br />IVW <br />(state) (Zip) <br />~>ev, ~ 141.11/ sr1{] <br /> <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 />RID <br />_ Rezoning <br />V Special Use Pennit <br />Vacation of Right-of-Way <br />== Prelllninary arrl Final Plat <br /> <br />$750 <br />$300 <br />$200 <br />$200 <br />$500 <br /> <br />_ CclTprehensive Plan Amendment <br />Division of Platted Lot <br />== Relocation of IMelli.rg <br />_ Variance to Zoning Ordinance <br />Shoreline Pennit <br /> <br />2. <br /> <br />Address of OWner: <br /> <br />3. <br /> <br />5eo it <br /> <br />4. <br /> <br />5. <br /> <br />$750 <br />$100 <br />$100 <br />$200 <br />$ 50 <br /> <br />(Phone) <br /> <br />L(fJ7-r 7o~ <br />(Phone) <br /> <br />~/J7 <br /> <br />6. Complete legal Description of Property Involved: <br />.5~e. allacAe<1 ('/-:-->Ih/{'t'f 11/( <br /> <br />7. Date Property Acquired: 0/0/\ o/frv Q <br /> <br />, <br /> <br />8. Present Use of Property: 6kfp'U t41:kL 9. Present Zoning of Property: S~c. <br />Proposed Use of Property: Proposed Zoning of 'Property: <br /> <br /> <br />10. <br /> <br />Present CoIrprehensive Plan Designation: <br />Proposed COIrprehensive Plan Designation: <br /> <br />~ <br />Ce..:I~ <br /> <br />11. <br /> <br />12. What is the expected effect of the proposed change? (For example, on property <br />values, health, safety, ~king, traffic conditions, etc.) <br />vel- 1N'1U"W\a.L <br />