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~SIMbbE PF 3:;2.~ r}_,\\ 1'(>/'2..-0--00./ I t) ,q , \ It "? \ . . , ' ,\; ,. ~ " Ul' 2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 PHONE: (651) 490-2279 FAX: (651) 490-2931 (City Code is available on the Internet. The address is: www.ci.roseville.mn.us). Please check item or items for which you are applying: ~ PUD $750 Comprehensive Plan Amendment Rezoning $300 ~ Minor Subdivision Conditional Use Permit $200 Relocation of Dwelling Vacation of Right-of-Way $200 Variance to Zoning Ordinance Preliminary & Final Plat $500 Interim Use Permit Labels to Affected Property Owners ($35.00 + $.25/label) $750 $100 $100 $200 $200 When applying for more than one approval, only one fee (the highest) is charged. Please complete form by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keying information to the proper item numbers: !D -6 51. '-I.~('J. :2.. bl g, 1. ~rome... K Krvefer- c, S 1 '~3 '8'14 Name of Owner: (First) (Middle) . (Last) (Phone) 2. IL/.D7 w. t: IJ"'ICLie..- Ill/e.. ,fmevjJl~ Address of Owner: (No. And Street) (City) So....VW\e... lAS OWYler Address of Applicant: (No. And Street) 5. I 'i? 4-4- H ~W\ h'A e.. ftve Street Address of Property Involved: (City) frlJJ '5'511 ~ (State) (Zip) (Last) (Phone) (State) (Zip) 3. s CL V\I\ e.. Name of Applicant: " S 0 u.J V\f2. r (First) (Middle) 4. 6. Complete Legal Description of Property Involveq: t X E {, J~ FT', W ?f3 bt S ~(p of- N '}t,,, 0+ N w '1'1- o-F SE It! r... 5,/1:,,\ 10 fit:>) I tJ SEC- / ~ T/J;)... 9 I?N 2.. 3 ) P IN -/I:- 15 ~ 7..). 3 >' 20 12... D 7. Present Use of Property: I D -;-.".hv{)J e 8. Present Zoning of Property: R / Proposed Use of Property: 10 r Proposed Zoning of Property: I? / 9. Present Comprehensive Plan Designation: Proposed Comprehensive Plan Designation: 10. What plan or change makes this request necessary? 7D dllt/G/O p 1-), e !oT