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<br /> <br />~SEVfbbE <br /> <br />':pF-~d-aS <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 $750 Comprehensive Plan Amendment $750 <br />Rezoning $300 Minor Subdivision $100 <br />Conditional Use Permit $200 Relocation of Dwelling $100 QcL f <br />Vacation of Right-of-Way $200 Variance to Zoning Ordinance ~OO ~ <br />_ Preliminary & Final Plat $500 _ Inter~ Vse ^ermit $200 ~ I <br />+~ ~~-D~~~t <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 />1. 'JAIn6S fR(1WL\S CAPI<:>T~IT~ <br />Name of Owner: (First) (Middle) (Last) <br /> <br />0~ / ~ L/fq ~7l.(f7 <br />(Phone) <br /> <br />3. <br /> <br />do3S- IV, V I ~ 10~, 14- fo~.eJ I' Jk fYJ Y\ . 5'5115 <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br />j'A<h f, c, ~R(tw<:.. \ <) (APISTRAW'l ~5/ - 'IJJ9-7</f7 <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br /> <br />2. <br /> <br />4. <br /> <br />50rn ~ Q '> Q~ II-<- <br />Address of Appl.: (No. And Street) (City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. <br /> <br />-5' Q (\'\ ~ <t ~ Q bov-L- <br />Street Address of Property Involved: <br /> <br />Complete Legal Description of Property Involved: ir 0 PQ..( ~ I (J <br />/4- J.~ ;;). 3 ~'-I 0 00 I (p c.. hJ.3 ' <br />~v'\ 1 t{ To,"" r\;).q f2 elf'\') e.. J.. '3 <br /> <br />NoJP,1J <br />I <br /> <br />6. <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />8. <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. \Vhat plan or change makes this request necessary? Tho{. a~J./+/~V' of at) <br /> <br />crtt Co <: h eJl <br /> <br />fj ~ I' 4 j'.fL....- <br /> <br />1 <br />