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:J..~IJ~ CITY OF ROSEVILLE 2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 , Please check item or items for wch you are applyin;J: RID - Rezonirg - Special Use Penuit )t vacation of Right-of-way _ PreliJninary ani Final Plat $750 $300 $200 $200 $500 _ CClJprehensive Plan ArrerXInent Divisioo of Platted IDt - Relocation of DNellin;J - variance to zooi.n;J Ordinance - Shoreline PeJ:mit $750 $100 $100 $200 $ 50 Please carple:t;e form by typin;J or printi.n;J in ink. If the spaces provided are insufficient, use additional sheets, keyin;J information to the proper item ntmIbers: . 1. ~,~r<'N~ D.PAA..7MSU'r Name of OWner: (First) (Middle) (last) (Phone) 2. Zb~~ QIV'~ C'C'N~h- t:)~ Address of OWner: (No. am street) (City) (state) (Zip) 3. ~E (Name of Applicant): (First) (Middle) (last) (Phone) 4. (Address of Appl.) : (No. am street) (City) (state) (Zip) 5. street Address of PI'q)erty Involved: ~ete ~iption of PI'q)erty ~: ~~~ ~~,..~ ~~"'!.I-'-' <: ~,,&: 6. 7. !:ate PI'q)erty AcqUired: 8. Present Use of PI'q)erty:~ 9. Pmsent zonirg of PI'q)erty: Proposed Use of PI'q)erty: ~~~."f Prc:posed zonirg of PI'q)erty: 10. Present Ccltprehensive Plan Designation: Prc:posed Ccltprehensive Plan Designation: 11. Wha.t..;plan or ctwge makes this request ~i;Sary? . ~...~ Cfto~~",,~u(:,"'CIJ~ ""-"'-b=_~ 0.:. rA~~ W~Ci.. 12. What is the expected effect of the prc:posed c::hange? (For exa:rrple, on property values, health safety, 0' traffic cx:n1itions etc.) _ :':~& &:~\""T''''_ _ _ ........ ~.....,.z a:;;:... l!:>> T...- 'Q.,_I~ l -;~ -r;.. ~,c.-w-......c. 12.\&"'.,..61='-......."'.