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<br />, <br /> <br />II <br /> <br />~SIMbbE <br /> <br />I <br />I <br />! <br />I <br />I <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 PHO~E: 490-2279 FAX: 490-2931 <br /> <br />Please check item or items for which you are applying: <br /> <br />/ <br /> <br />POO <br />Rezoning <br />Conditional Use Permit <br />Vacation of Right-of- Way <br />Preliminary & Final Plat <br /> <br />5750 <br />S300 <br />$200 <br />$200 <br />$500 <br /> <br />Comprehensive Plan Amendment <br />Minor Subdivision <br />Relocation of Dwelling <br />Variance to Zoning Ordinance <br />Interim Use Permit <br /> <br />S750 <br />SIUO <br />SiOO <br />S200 <br />S200 <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 />L.Otl-Eb& <br />Name of (fivner: <br /> <br />~Of' E(2....n€..5 IrJL. <br />(First) (Middle) <br /> <br />( Phone) <br /> <br />I <br />I <br />II <br />f;r:e~iJJre!:~~~,;;::,~{;!~:.lo/ -- .-------- II <br /> <br /> <br />Complete Legal Description of Property Involved: LIJ/ t/ 8U;:Jc.~ Z- I I <br />Cc)/...i%b€ PIUJ/>Ea'Tlr:<... //7)"/)/"0"/ - 1-Ior6'- PJ,J4t o'-/- Z'-Z3-/&/- DO,O <br />~AtI.t.AtJ,- Ptr-Jyt: 0'1-2..9- "Z 3- ''-1-00'' I <br /> <br />Present Use of Property: I~/R~ Present Zoning ofPropertj: IVb I <br />Proposed Use of Property: ~J i 2GST. Proposed Zoning of Prop.: Pa];;, II <br /> <br />Present Comprehensive Plan Designation: fu~ II <br />Proposed Comprehensive Plan Designation: J u'A I <br /> <br />What plan or change makes this request necessary? ;./0=1- 6cp A. rJS ll"rJ I <br /> <br />~h~IT(OrJ of 4stAlAlAtJT. o;j I <br />.J\.~ II <br />\~'\;I <br /> <br />2. <br /> <br />322-0 !..AK.& JDdA]JNA <br />Address of Owner: (No. And Street) <br /> <br />3. <br /> <br />;1114 te.K. <br />Name of Applicant: (First) <br /> <br />T: <br />(Afiddle) <br /> <br />4. <br /> <br />3Z20 t41LE JDH4rJ,J/+ 8l-vb,.. <br />Address of Appl.: (No. And Street) <br /> <br />5. <br /> <br />6. <br /> <br />7. <br /> <br />9. <br /> <br />10. <br /> <br /> <br />(Last) <br /> <br />Bl- V2:::>, <br />(Ci ty) <br /> <br />..4/'2.);}6rJ /-/'1.-1-5 /..MrJ 5511 L <br />(State) (Zip) <br /> <br />./f.AeYEtL <br />(Last) <br /> <br />&51- b3i-boo9 <br />(Phone) <br /> <br />~,L/t:~'bE:rJ /I'LL..:> . <br />(Ci!)) (State) , <br /> <br />MA 5~/JL <br />(Zip) <br />