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<br />~ <br /> <br />~SIMbbE <br /> <br />~C4~ ~(l'l//q't <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 Pennit <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 />Variance to Zoning Ordinance <br />Interim Use Permit <br /> <br />$750 <br />$100 <br />$100 <br />$200 <br />$200 <br /> <br />When applying for more than one approval, only one fee (the highest) is charged. Please <br />complete fonn by typing or printing in ink. If the spaces provided are insufficient, use additional <br />sheets, keying infonnation to the proper item numbers: <br /> <br />1. <br /> <br />Name o/Owner: q;;~{{j L- tfidcJ~ ~ <br />.20-0G:) /U tU-/n,,'T ~'/. ~s~vJ tie- <br />Address of Owner: (No. And Street) (City) <br /> <br />~I 6"33-&9/2- <br />(Last) (Phone) <br /> <br />2. <br /> <br />,41 /f.,,/ <br />(State) (Zip) <br /> <br />3. <br /> <br />~ v) cf <br />Name of Applicant: (First) <br /> <br />4. <br />(Middle) <br /> <br />r;~k~ 612 3<1't.ol('8J <br />(Last) (Phone) <br />uS~G' L <br />mtP/t S" pt/f/ ~ <br />(State) (Zip) <br /> <br />4. <br /> <br />qoCJ :J. ~ cI Hv-t!-. .5. .$-f.e. 7&'~ <br />Address of Appl.: (No. And Street) (City) <br /> <br />5. <br /> <br />2v-0 7 W~ ( ;L(.; r- 6' 'f- . <br />Street Address of Property Involved: <br /> <br />fJlJ S ~ vJ tiP... M JPt/. <br />, <br /> <br />6. Complete Legal Description of Property Involved: 191\. () (~ . <br />1 <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 />$2 <br />;::Cz. <br /> <br />9. Present Comprehensive Plan Designation: 8::"", d v.$ i/ ) t/( <br />Proposed Comprehensive Plan Designation: . <' <br /> <br />10. What plan or change makes this request necessary? 76 ,t;)/bV' ~c.- I"e::tll/'oec,ct <br />, <br /> <br />:5,/)(/".- f-t) j)/() ;!/I se ~ <br />I I / <br /> <br />SIJ()_ . <br /><r <br /> <br />1 <br /> <br />')-\')..ct 0\ <br />