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<br />w.. "1 <br /> <br />~SIMbbE <br /> <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 Phone: 651-490-2279 Fax: 651-490-2931 <br />E-mail: dennis.welsch@cLroseville.mn.us <br />(City Code, Zoning Map and Comprehensive Plan Map are available on the Internet at: <br />www.ci.roseville.mn.us ) <br /> <br />Please check item or items for which you are applying: <br /> <br />~lOO <br />~ <br /> <br />PUD $750 Comprehensive Plan Amendment $750 <br />Rezoning of Site $300 ~ Conditional Use Permit $200 <br />_ ' Zoning Text Amendment $300 Minor Subdivision $100 <br />Vacation of Right-of-Way $200 Relocation of Dwelling $100 <br />Vacation of Easement $200 Variance to Zoning Ordinance $200 <br />Preliminary & Final Plat $500 Interim Use Permit $2~ <br /> <br />When applying for more than one approval, only one fee (the highest) is charged. Please ~ <br />complete this form by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets and refer the information to the proper page and item number. All <br />applicable items must be completed and all required information attached for the application <br />to be accepted as complete. In order to be considered by the Planning Commission and <br />City Council, the applicant must be present at the meetings. '/" t:J?fl <br /> <br />L AV r D GE\)R f S 0\ B E ~ tDJJi-lVt~- J(} <br />(First) (Middle) (Last) (Phone)(Fax b(o~ <br />.3 f () 11 f A I & V II:W Av!:- R~ml~~r rMI. 5"5" W ~ <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />Name of Owner: <br /> <br />2. <br /> <br />3. <br /> <br />)1\f'J\t <br /> <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Ph on e)(Fax) <br /> <br />4. <br /> <br />Address of Applicant (No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. 3 \ ~ 4 F A I R V I E IN A V rJ <br /> <br />Street Address of Property Involved: <br /> <br />7. Present Use of Property: <br />Proposed Use of Property: <br /> <br /> <br />6. <br /> <br />,P~ge 1 of 5 <br /> <br />'-'.~ <br />