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2660 CIVIC CENTER DRIVE ROSEVILLE, MINNESOTA 55113 PHONE: (651) 490-2279 FAX: (651) 490-2931 (City Code is available on the Internet: www.ci.roseville.mn.us). CONDITIONAL USE PERMIT APPLICATION (CITY CODE SECTION 1013) , -.....,.. o f) o RESIDENTIAL PROPERTY OWNER FEE - $150 BUSINESS/INDUSTRIAL FEE - $300 CITY PROVIDED PROPERTY OWNERS LIST/LABELS FEE - $45 (All fees payable upon submittal of completed application) -... Applicants are responsible for placing a City provided "NOTICE OF LAND USE ACTION" sign on the subject property at least, 10 days prior to the scheduled hearing before the Planning Commission or City Council. ~ '- Please complete the appliCation by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keying information to the proper item numbers: 1. Name of Owner: (First) (Middle) (Last) (PhoJle) City of Roseville 2. Address of Owner: (No. And Street) (City) (State) (Zip) 2660 Civic Center Drive, Roseville. MN 55113 3. Name of Applicant: (First) (Middle) (Last) (Phone) QWEST Wireless, L.L.C. 4. Address of Applicant: (No. And Street) (City) (State) (Zip) 426 N. Fairview Avenue. St. Paul, MN 55104 5. Street Address of Property Involved: Fire Station #3. 2335 Dale Ave, Roseville. MN 55113 6. Complete Legal Description of Property Involved & PID No. (below or attached): , PID 11.29.23.41.0082 Copes Subdivision of lot 1 subj to rd; the N 134 ft of E 247 ft & N 131 ft of W 78 ft of E 325 ft of lot 12 7. State exactly what is intended to be done on or with the property that requires the conditional use permit: The construction of a 60 ft. PCS tower. .' , . ' Page 1 0 f 2 ::.