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<br />\ <br /> <br />t) <br /> <br />Y 112- "r7': . ' JI17 .P ^ <br /> <br />~ ILl' IltL <br /> <br />~-r. <br />"IV <br /> <br />" - <br />-;::;. <br /> <br />~SI3VfbbE <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is available on the Internet: www.ci.roseville.mn.us). <br /> <br />Planning File: <br />Please check item or items for which you are applying: <br /> <br />.~ <br /> <br />y <br /> <br />PUD $750 <br />Rezoning $300 <br />Conditional Use Permit $200 <br />Vacation of Right-of-Way $200 <br />Preliminary & Final Plat $500 <br />Labels: Affected Property Owners ($45.00) <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 />$200 <br /> <br />When applying for more than one approval, only one fee (the highest) is charged, Please <br />complete form by typing or printing in ink, If the spaces provided are insufficient, use additional <br />sheets, keying information to the proper item numbers: z}b- Jf1 thf k C) ~ fe...JJ <br /> <br />1. C(?O()( (),'/ ~lVIbJ/kA/(/ ~.5I-~39-57~5 <br />Name of Owner: (First) (Middle)' ( (Last) (Phone) <br /> <br />/7L/t .s;. ~f\e ~ I c;.i .51-. d;"/wft--~ 111-<1 <br />Address of Owner: (No. And treet) (City) (State) <br /> <br />2. <br /> <br />3, <br /> <br />4. <br /> <br />5. <br /> <br />6, <br /> <br />7, <br /> <br />71e..~ jc)/t~. <br />Name of Applicant: (First) <br /> <br />/3.10 iU_, 4--- E <br />Address of Applicaftt: (No. And Street) <br /> <br />S--s;-a"6"7 <br />d(Zip) <br />v(! ~fZ~-~b(;;( <br />h/lv.$ e4 6S/-~ 3.5=- 9-.5"""77 <br />(Last) (Phone) <br /> <br />5c.o 7'/- <br />(Middle) <br />A~~ dJg <br />(City) <br /> <br />&1/ <br />(State) <br /> <br />.s-S-dL.- <br />(Zip) <br /> <br />Street Address of Property Involved: <br /> <br />Complete Legal Description of Property Involved: <br /> <br />Ex (I.' ~ ,~ -I- 14- <br /> <br />Present Use of Property: <br />Proposed Use of Property: <br /> <br />8. <br /> <br />Present Zoning of Property: <br />Proposed Zoning of Property: <br /> <br />9. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br /> <br />10, <br /> <br />A-jJ <br /> <br />I <br /> <br />CA-R tV ~'S h <br /> <br />What plan or change makes this request necessary? <br /> <br />1 <br /> <br />-r 5k('~. <br />, <br />