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<br />R9~ <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVlLLE, 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- W ay <br />Preliminary & Final Plat <br /> <br />$750 <br />$300 ~ <br />$200 <br />$200 -X- <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 />$200 <br /> <br />When applying for more than one approval, only one fee (the highest) is charged. Please <br />complete form by typing or printing in ink. If the spaces provided are insufficient, lJse additional <br />sheets, keying information to the proper item numbers: . ~. .,511>'" <br /> <br />1. <br /> <br />S'E-'1'~ <br />Name of Owner: (First) <br /> <br />S~\1 ~\\- <br />(Last) <br /> <br />~.:ss - \ 112- <br />(Phone) <br /> <br />2. \q~~ CL8\J~~ M~ 0c0~~\u..~} tJ\N ~\l3- <br />Address of Owner: (No. And Street) (City) ) (State) (Zip) <br /> <br />::J~~ <br />(Middle) <br /> <br />3. <br /> <br />Sc=:<'"\\r\ S-~~ <br />Name of Applicant: (First) <br /> <br />.~~~~ <br />(Middle)/ (Last) <br /> <br />4. <br /> <br />r\C\L cl-wu~ ~ N. ~~\\<2- N\N <br />Address of Appl.: (No. And Street) (City) (State) <br /> <br />,qqc?- clQJ)~ fwL N \ ~~ \\~ V\~ <br />Street Address of Property Involved: <br /> <br />5. <br /> <br />\o~5 -\ 11. 'L <br />(Phone) <br /> <br />SSl\6 <br />(Zip) <br /> <br />s:S" \ \ :s <br /> <br /> <br />~ 1<{.2S <br />~~~ t$~U. <br /> <br />6. <br /> <br />7. <br /> <br />9. <br /> <br />Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />10. <br /> <br />What plan or change makes this request necessary? U <br /> <br /> <br />~QI k <br /> <br />~'Qqq <br /> <br />1 <br /> <br />Gv(\ <br />'^- \ ~< <br />