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<br />Rl'SIWIbbE <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 & Pinal 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 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 />~/~-3?/- 35~5 w <br />&5 /-tffll-l/77(P <br />(Last) (Phone) <br /> <br />As8 AJ f/!f1tarflJJ1S I3j,;d Pos~{)/I/e )IV S-SI/3 <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />1. <br /> <br />Mark- <br /> <br />Name of Owner: <br /> <br />:John <br />(First) <br /> <br />2. <br /> <br />3. <br /> <br />Mart John <br />Name of Applicant: (First) <br /> <br />fit? fl5Oj? <br />(Middle) <br /> <br />-fh n~J1 <br />(-Middle) <br /> <br />.3t1 nv4a- ~ <br />(Last) (Phone) <br /> <br /> <br />4. 'IV 5~ II <br />(City) (Zip) <br />5. ~tJ JJ U('(br(Of):5 13/od ~()I/k UJJ 55//3 <br />!)t1;eelAddress pfPrpperty Involved: 6' h~ '1'>, JJ) <br />(FWleYty 41~C:S t::IIcJW~ tu- 3;J.O IV .,.,."'~S '" "'G{- <br />6. Complete Legal Description of Property Involved: ,La/- ~ jmr!o..ns <br />5a bd!oISJrrv-.- <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />~~cr <br />~ <br /> <br />8. <br /> <br />Present Zoning of Property: <br />Proposed Zoning of Prop.: <br /> <br />IJ..s <br />I~ <br /> <br />9. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: c~ <br /> <br />10. What plan or change makes this request necessary? <br /> <br />I <br />