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<br />CitY- of <br />~SI3VfbbE <br /> <br />Minnesota <br /> <br />~uJAW~ <br /> <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 Phone: 651-490-2279 Fax: 651-490-2931 <br />E-mail: dennis.welsch@ci.roseville.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 />PF# <br />Please check item or items for which you are applying: <br /> <br />PUD <br />Rezoning of Site <br />Zoning Text Amendment <br />Vacation of Right-of-Way <br />Vacation of Easement <br />Preliminary & Final Plat <br /> <br />$750 <br />$300 <br />$300 <br />$200 <br />$200 <br />$500 <br /> <br />I <br /> <br />Comprehensive Plan Amendment$750 <br />Conditional Use Permit $200 <br />Minor Subdivision $100 <br />Relocation of Dwelling $100 <br />Variance to Zoning Ordinance $200 <br />Interim Use Permit $200 <br />Mailing Labels $35.00 + $.25I1abel <br /> <br />When applying for more than one approval, only one fee (the highest) is charged. Please complete this <br />form by typing or printing in ink. If the spaces provided are insufficient, use additional sheets and refer the <br />information to the proper page and item number. All applicable items must be completed and all required <br />information attached for the application to be accepted as complete. In orde 0 be considered by the <br />Planning Commis .on and City Council, the app 'cant must be pre at the meetings. <br /> <br />1. "-IfV~-& . ,. ~. [- #q'-9~q3 <br />Name of Owner: (First) (Middle) ,-/) (~ast) hone)(Fax) <br /> <br />2. ~ /g;s- dR-I( fi~jf- W~R-/I1ti au) ss 1/3 <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />3. <br /> <br />Name of Applicant: (First) <br /> <br />4. <br /> <br />Address of Applicant <br /> <br />5. <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) (Fax) <br /> <br />(No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />Street Address of Property Involved: <br /> <br />6. Complete Legal Description & Pin Number of Property Involved (may attach): <br />/'I-,J. q - 23 -II -OrJ3! <br /> <br />7. <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />RE <.i j~ VP haj:', <br />e; IJ It.: !:.v <br /> <br />Page 1 of5 <br />