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<br />~ <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 PHONE: 490-2279 FAX: 490-2931 <br /> <br />Please check item or items for which you are applying: <br /> <br />PUD <br />Rezoning <br />Conditional Use Permit <br />-X- Vacation of Right-of-Way <br />Preliminary & Final Plat <br /> <br />$750 <br />$300 <br />$200 <br />$200 <br />$500 <br /> <br />Comprehensive Plan Amendment <br />Minor Subdivision <br />Relocation of Dwelling <br />Variance to Zoning Ordinance <br />Shoreline Permit <br /> <br />$750 <br />$100 <br />$100 <br />$200 <br />$ 50 <br /> <br />When applying for more than one approval, only one fee (the highest) is charged. Please <br />complete form by typing or printing in ink. If the spaces provided are insufficient, use additional <br />sheets, keying information to the proper item numbers: <br /> <br />R.s..,-",-\"'V' ~t"""~I't& j)en:-"f"LTM_~T <br />Name of Owner: (First) (Middle) (Last) (Phone) <br /> <br />2"(,0 G v' c:.. G ~ -, -"'- 3:)t\..\v.. <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />~fE" <br />Name of Applicant: (First) <br /> <br />1. <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />~MC <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />Address of Appl. : <br /> <br />(No. And Street) <br /> <br />(Zip) <br /> <br />~c:>~,.-ruee.,- <br />Street Address of Property Involved: <br /> <br />Complete Legal Description of Pror;; Involved: ;;En.... 4~) 'Tu '" <br />h\4D. 3, f21..W\.~ \,,)N",,\J I NN ~,... <br /> <br />5. <br /> <br />(City) (State) <br />I:a., -,; \.. \Tt-o^C: <br /> <br />6. <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />~ <br />~ <br /> <br />8. <br /> <br />Present Zoning of Property: ~ 6t <br />Proposed Zoning of Prop.: ~. <br /> <br />~A- <br /> <br />Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />10. What plan or change makes this request necessary? Q\...e:z:a.t'L \\ 'T '-- ~ <br /> <br />9. <br /> <br />I <br />