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<br />iI~ <br /> <br />t <br /> <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 />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 />r/ 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 />1. <br /> <br />STuM.. -r Q fl,fr8-lE S/::~, C/tlliJu:: N J'IFLJ-ItI{J <br />Name of Owner: (First) (Middle) (Last) (Phone) <br />II qq aoJ(;;-yJ(--I1.~ I21>r flo;jEVI~ NN ~~{f 3- <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />2. <br /> <br />3. <br /> <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />4. <br /> <br />Address of Appl.: <br /> <br />(No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. /141 ff.:t::rs efJ t77ft/? I?-~ <br />Street Address of Property Involved: <br /> <br />6. Complete Legal Description of Property Involved: S;cc::...710N 3 Tcwt-J 2-e:; <br />f2ANc.. t ~3 S u(3 T "TZ> a-og E'P trlve; (<) Atv'D ex <br />~€c.3 '1/V' ~tv 23 <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />8. <br /> <br />Present Zoning of Property: <br />Proposed Zoning of Prop.: <br /> <br />9. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />10. <br /> <br />What plan or change makes this request necessary? <br />(J,~ ~c ~ TIta:::./v r q-o Hv use? ~ <br />/ AI I ~ P L.Itc.E: <br /> <br />Ilc~vffL 01=- ot-b <br />tJ-t)U;$E ~loN <br /> <br />1 <br />