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<br />.JAfl. lS. 1':\97 Z: ~:?P(,l _CT': Qf" R0SEVI\..Lf" <br /> <br />NO.114 p.~/r;; <br />" -.--- -,- - <br /> <br /> <br />~660 CIVIC CENTER DRIVE <br />ROSEVILLE. MINNESOTA 55113 PHONE: 490-%179 FAX: 490-2931 <br /> <br />Please check it<:m or items for which you Iij'(' applying: <br /> <br /> PUD $750 Comprehensive Plan Amendment 57S0 <br /> Rezoning $300 Minor Subdivision $100 <br />~ ConditilJna) Use Permit $200 Relocation of Dwelling $100 <br /> Vacation of Right-of- Way $200 -L Variance to Zoning Ordinance $201) <br /> Preliminary & Final Plat $500 - ShQreline Pennit $ SC <br /> <br />When applying for mOte than one approval, only one fee (the highest) is charged, Please <br />complete fom, by typing or printing in ink. If the spaces provided are lnsufficient, use additio .1al <br />sheets, keying i.nfonn~tion to the proper item numbers: <br /> <br />1. f1Bt\j jt)1~~ (CooS) ~-42 - 9\21 <br />Namt olOwncr (First) (Middle) (LasO (PhoYle) <br /> <br />2. 3~~ ~\~'L. CO~ Avet-:Ju~ ~~~"'\ '50. 51~_ <br />Add1'rSS (~fOw~e'" (No. And Street) (Ciry) (State) (Zip) <br />(51~~S6,~.2, il.2<P <br />3. ~-P . c..o~~~<,-~ O~ (;m~ )--:I:Nc. Mr. ~Ioo)N\.f. D. ~M\~ €>cf, I~\ <br />Name (~fA.pp/rc(mt: (First) (Middle) (Lcl:Jt) (Pho/te) <br /> <br />4. Bo5c A~rpt)N-- ~~ G:.eo~:toWt0)-rx. ]9CD2B <br />Add,'ess of Appr. (No. A"d Street) (City) (Statd) (Zip) <br /> <br />5, 2~ H.o~ 5t.J~I\'N~ ~o~v\\\~\ M~ :;'51\~ <br />Street Address' of Property I11VO/vld: <br /> <br />6, Compl(~te Legal Description ofPropcrty Involved; ..A.~c.. ..r A r-r; f C I. / <br /> <br />_...-~- <br /> <br />7. Prescn1 LJse ofPropel'ty: ' ~r~. ,'. co L ~ 1-8. Present ~ning ofPropcrtv: Ji_::_l-, <br />Proposed Use of Property: B ~~~~ ~ Proposed Zoning of Prop,>,.... .;13.... 2.. , <br /> <br />9. Present Comprehensive Plan Designation;....:.-~,4-t. i IS... J ,,(-L.{ <br />Proposed Comprehensive Plan Designation: _ J2~ I ~~'.;,) ~ ( ,I <br /> <br />) O. \\'hat pl3.11 or change mllkes this request necessary? <br /> <br />20/GO 'd <br /> <br />2VVS-698-219 'ON X~j <br /> <br />dnO~D NDIS3Q/33~8W3 Wd OV:VO 3nl L6-12-NYf <br />