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r- ". ........... , ' R(.t:e.;~ 1I-ID.t:t7 ~ ~ 2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 PHONE: 490-2279 FAX: 490-2931 Please check item or items for which you are applying: ~ PUD $Z?.O Comprehensive Plan Amendment $750 ~ Rezoning $N.O Minor Subdivision $100 Conditional Use Permit $200 Relocation of Dwelling $100 Vacation of Right -of- Way $200 Variance to Zoning Ordinance $200 V Preliminary & Final Plat $500 Shoreline Permit $ 50 - When applying for more than one approval, only one fee (the highest) is charged. Please complete form by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keying information to the proper item numbers: 1. ~ 7J/1J4Af1~ /3flGl..J;JC ~n,a4~V Name of Owner: (First) (Middle) (Last) c-17~r P4f111vt Rtf .5:t~L Address of Owner: (No. And Street) (City) (Phone) 2. 1/11) (State) ~~I/~ (Zip) 3. 4. Name of Applicant: (First) (Middle) (Las!). (Phone) . .'.. &,)X tJU. q.hJ./-'905'~" ~NtJ071l I'fu1-Jt.;S ~1]J'-- fb;1.t;,!:lIA'a.:. 'fbJ../-.:t05"br4X Address of Appl.: (No. And S~ee~) ;. ~ (City) ..' (State) ._ (Pip) /Vli:..:.<1 /.,4 R,.-I;:. btftf k3'1;L ~37 ~O I!I)W'TH()i,.j III,.}! bPI .,. ,3~f/ FA y Street Address of Property Involved: 5. 6. Complete Legal Description of Property Involved: 7. v-i[A,J J Present Use of Property: ~i::;) Proposed Use of Property: 30 l..t1l/r c..o i1 /j 0 m ,,., I L.t-'wt Present Comprehensive Plan Designation: Y - 3 Proposed Comprehensive Plan Designation: R - 3 What plan or change makes this request necessary? Pf1.cIto'l'tzt I~ no7" "14N\c;. d A<wlll r k 1Ut. j) Rt, '2-' . LU I tl \ \ t> ~I\ I 1'D ~ \.\~t\ ~~.)1t(\'\] tD Q....", r,-1tJH),\~I~ \A.I\J . 8. Present Zoning of Property: 'R -, Proposed Zoning of Prop.: l?- ~ 9. 10. 1