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<br /> <br />CITY OF ROSEVILLE <br />2660 CIVIC CENTER DRIVE <br />RCSmLLE. ~OTA 55113 <br /> <br />Please c:hedc item ar items fO!:' ..-trich 'i~'l a..-re awl~: <br /> <br />_ Pl1D <br />-~ <br />_ Special Use Pel:m.it <br />Vacatiat of Right-of~I <br />= P.!:el.iminary an! Final Plat <br /> <br />$750 <br />$300 <br />$200 <br />$200 <br />$5ro <br /> <br />C:IIprehensive Plan A:gerD::!ent <br />- Divisicr. of Flatte.j Lot <br />- !elocatiro of DoIellin;; <br />-;:- \'ari.arn= to Zc:nirq 0:nti.."Ia.""Ire <br />- ShorEl.i..1E Fermit <br /> <br />$750 <br />$lO~ <br />$!OO <br />$200 <br />$50 <br /> <br />Please 1XIIp1ete tam by \..-ypinJ or F.:-inti.~ i.?1 :u-.k. If the spaces proIlided a..ore <br />insufficient, use additicnal sheets, kEyi.."1;j :,.--.fc.rnatic:r. to the prqer iten lUItJers: <br /> <br />1. ~",S~ILLE Pi?-O~ <br />Name of ~: (Fi...-st) <br /> <br />Z,c;1(. N, ~i2.;//E\v' # 2C;C <br />Address of Ow.--er: (No. am St:reet) <br /> <br />~e) <br /> <br />(Iast) <br /> <br />(R1one) <br />5~ 113 <br />{Zip) <br /> <br />2. <br /> <br />V-.. ,s...--v' JU....(' <br />(city) <br /> <br />(UN <br />(state) <br /> <br />3. <br /> <br />tA."f:L ':"" <br />(Name of }gUicant) ~ (FL.TSt) <br /> <br />~, <br />P-tid:Ue) <br /> <br />~ t:...N€. <br />(last ) <br /> <br />l>';3-b~I'- <br />(Phone) <br /> <br />4. <br /> <br />~~ <br />(1dtress of ~.): {No. am street> (City) <br /> <br />(qS~ 11 (,-~p &1... MJt> ?\t~11- <br />Street Adt'iress o~ PrqIe-'"ty Involved: <br /> <br />{State) <br /> <br />(Zip} <br /> <br />5. <br /> <br />6. QJlpl"!te legal Des::rip'-..ion of ~ I."",~h>Qj: ~ MTk--.1) <br /> <br />7. <br /> <br />ntte Property Aapi.ra1: <br /> <br />i~1S' <br /> <br />8. <br /> <br />!>resent Use of ~: <br />PrqJosej Use of ?rqJerty: <br /> <br />9. Present Zonin;] of Property: <br />P.t~ Zoning of ~: _ <br /> <br />10 - Present C:IlprPhensi..~ Plan Designation: <br />Prcpcsed a:mprehensi-..e Plan DesigN'oltion: <br /> <br />11. ~.at pla.") or d1ange makes this request ~TY? <br /> <br />12. MKit~.s the ~ effect of the p~ charge? (Fer e>::a1;pl.?, on prcpe:.""bj <br />values, healti1, safety, parki1)~.. traffic .:xn:litioos, etc.) <br /> <br />--- <br /> <br />--- <br />