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<br />~ <br /> <br />PF ~II 'J- <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 -X- <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 Pennit <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 />C9tL ~. <br />(Middle) (Last) <br />/!ofWIUl M~. <br />(City) (State) <br /> <br />1. <br /> <br />1}.vMAJ' )J(;.IL. <br />Name of Owner: (First) <br /> <br />2. <br /> <br />J11j 4tYt06J ~, <br />Address of Owner: (No. And Street) <br /> <br />3. <br /> <br />S-~c. <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />4. <br /> <br />IPS-J - /;11-1171 <br />(Phone) <br /> <br />S-S-II'1 <br />(Zip) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />Address of Appl. : <br /> <br />(No. And Street) <br /> <br />(Zip) <br /> <br />5. <br /> <br />I02~ ~ 101" <br />Street Address of Property Involved: <br /> <br />(City) <br /> <br />(State) <br /> <br />S}-tyV( C/Z Ave. <br /> <br />6. <br /> <br />Complete Legal Description of Property Involved: <br /> <br />~tf~ <br /> <br />7. <br /> <br />8. <br /> <br />Present Zoning of Property: <br />Proposed Zoning of Prop.: <br /> <br />~ <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />~ <br />~ <br /> <br />9. <br /> <br />Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />ks- I () t!J r1 ,4-L <br />~f 11)6../ n .4-\- <br /> <br />10. What plan or change makes this request necessary? <br /> <br />Ct+fJJ4 1~4 l. t-~ \S'I,J~ lto-rS ,AlTO '3 L.o lS <br /> <br />1 <br /> <br />"'\ G\... '\ <br />""J''');. <br />