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<br />II <br /> <br />~ <br /> <br />I <br />I <br />I <br />I <br />I <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 />V' Conditional Use Permit <br />Vacation of Right-of-Way <br />Preliminary & Final Plat <br /> <br />$750 <br />5300 <br />$200 <br />$200 <br />$500 <br /> <br />Comprehensive Plan Amendment <br />Minor Subdivision <br />Relocation of Dwelling <br />Variance to Zoning Ordinanl~c <br />Interim Use Pennit <br /> <br />5750 <br />SlOG <br />5100 <br />S200 <br />S20U <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. lfthe spaces provided are insufficient. use additional <br />sheets, keying infonnation to the proper item numbers: <br /> <br />LC?'{'l :-1 ~.... L~){ ct ;c'1 LL L <br />Name of CM.nif: '(First) (Middle) <br /> <br />[1~"",~~~ Vi. U <br />(City) (State) (lip) <br />~5l) I <br />l'< l ,=,-k.';.o f j:: ('t) 7 r:3 - 0 S' '-/ <br />(Last) C:v f{;lffl61-1{C( S'.,. I <br />(~ t-j S-~ ( <:; <'.c, I <br />(State) (liP) II' <br /> <br />II <br /> <br />, ' <br /> <br />36 7() I~.J5 ~.r- <br />Addg'g of ~ne1-rI!..Ncr;.~t!Jo/1) <br /> <br />~ ...- <br /> <br />-JAMt.'> _Jc~El'r+- <br />Name of Applicant: (First) (Middle) <br /> <br />1. <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />9 "'-r r,,( ~Ho tJr- <br />Address of Appl.: (No. And Street) <br /> <br />5. <br /> <br />__~ g '> __ l.) j 0 tvi-J C. <br />Stt:eet Address of Property Involved: <br /> <br />(LasT) <br /> <br />(G ().) <br />-;!) 5 - / , " 'J> <br />( Phonc,) <br /> <br />S <;'"" '-(6.2. <br /> <br />S f () 4vL <br />(Ci(r) <br /> <br />--------------.. . <br /> <br />6. Complete Legal Description of Property Involved: <br /> <br />7. <br /> <br />Present Use of Property: (. Ct"t~J'~.u I 8. <br />Proposed Use of Property: ~ L-t: I.:-.A ( ~ J-'-f <br /> <br />9. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />Present Zoning of Property: <br />Proposed Zoning of Prop.: <br /> <br />10. <br /> <br />What plan or change makes this request necessary? <br /> <br />I <br />- I <br />~f-'\~ i <br />