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<br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is available on the Internet: www.ci.roseville.mn.us). <br /> <br />INTERIM USE PERMIT APPLICATION <br />(CITY CODE SECTION 1012.09) <br /> <br />'t <br />o <br /> <br />RESIDENTIAL PROPERTY OWNER FEE - $100 <br />BUSINESS/INDUSTRIAL FEE - $200 <br />CITY PROVIDED PROPERTY OWNERS LIST/LABELS FEE - $45 <br />(All fees payable upon submittal of completed application) <br /> <br />Applicants are responsible for placing a City provided "NOTICE OF LAND USE ACTION" sign on the subject <br />property at least 10 days prior to the scheduled hearing before the Planning Commission or City Council. <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br /> <br />1. <br /> <br /> <br />(Phone) <br /> <br />2. <br /> <br />(First) (Middle) (Last) <br />R+-~ \.e~f"\ (V\Ar l~ A (\eSS <br />(No. And Street) (OM (State) <br />h~~("'\ (\AAfl~-e... ~ f\e<.;;.s <br />Name 0 Applicant: (First) (Middle) (Last) (Phone) <br />07~L/o ldbor~ ~oaj Ll~~t(. G~~. m~ ~ID9 <br />Address oj Applicant: (No. And Stre~b (City) (State)' (Zip) <br />tOo . rn <br /> <br />(051- Y~'~-Ll~33 <br />(Zip) X''2J~ <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br /> <br /> <br />l 13 <br /> <br />6. Complete Legal Description oj Property Involved & PID No. (below or attached): <br /> <br />UJa.-/ OeS"crlp~;D^ - ~ ~cJ.eD '&~'b.:,. }4' <br />fJ I fJ.;. / ,- '2 <1 - 2-3 - 33- aoen... <br /> <br />7. State exactly what is intended to be done on or with the property that requires the interim use <br /> <br />- permit" U S-<- fro(Xr+-i +6 1: CH+I<-e U~ <br /> <br /> <br />Phone # <br /> <br />Fax # <br /> <br />10f2 <br /> <br />~ <br />