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<br />.II" <br /> <br />.. <br /> <br />? F~f ~1 <br /> <br />QQPM-P <br /> <br />~SIMbhE <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 <br />$200 <br />$200 7- <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 />~t-Iv <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, use additional <br />sheets, keying information to the proper item numbers: <br /> <br />Address of Owner: <br /> <br />(No. And Street) <br /> <br />J-j ef( t9-?6bJIr31 <br />I (Last) (Phone) <br />S J, (lost,)) / ~ /;f Il/ S '"S7 / 3 <br />(City) (State) . (Zip) <br /> <br />1. <br /> <br />fc. /,) IA.I f/--tlc) s:. <br />Name of Owner: (First) (Middle) <br /> <br />J-77 ( WlJV.D~/)L1L <br /> <br />2. <br /> <br />3. <br /> <br />3Ifyu 6 <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />4. <br /> <br />~.L <br />Address of Appl.: <br /> <br />(No. And Street) <br /> <br />(City) (State) (Zip) <br />S J. (k;~wll ~ / fl\rJ '5)? /3 <br /> <br />, <br /> <br />5. <br /> <br />,;- 7 ? ( v...JIJV ,";) (!.lZ..-I I) q L <br />Street Address of Property Involved: <br /> <br />-- 6. <br /> <br />Complete Legal Description of Property Involved: <br /> <br />1- .)9; - ~3,,4 I - OD 7 7 <br /> <br />7. <br /> <br />Present Use of Property: ((~ U/hJ/.,...J 8. <br />Proposed Use of Property: <br /> <br />Present Zoning of Property: ~ <br />Proposed Zoning of Prop.: <br /> <br />.... 9. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />10. What plan or change makes this request necessary? q, fJJ?1/J <br />, <br /> <br />1 <br />