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<br />ern OF ROSEVILLE
<br />2660 CIVIC CENTER DRIVE
<br />ROSEVILLE, HIBNESOTA 55113
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<br />Please d1eck item or iw.6 far whi.ch you <L--e applying:
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<br />roD $750 QapLebensive Plan ImIeJdment $750
<br />- RezaniDJ $300 - Divisicn of Platted LX $100
<br />::8: Special Use Pe1::IIit $200 - Relocation cf DwelJ.iRJ $100
<br />_ Vacat1at of Right-of-1lay $200 X Variance to zcmi.Jq 0J:dinarx::e $200
<br />_ Preliminary and Final Plat $500 Shoreline Pa:mit $ 50
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<br />Plsase caIpletA fot.1R by typin:J or print.ing in ink. If the spaces prorided m:e
<br />irmufficient, use additi.aal sheets, kayiIq infon!ation tx> the proper item udWIO:tt:'$:
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<br />1. C"e;t\}L C~TI r..\V(S+Mt-of\\ S;
<br />Nama of Qmer: (First) (Middle)
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<br />:;}'1 (. ~CI..4 Th A \~1ei[__ Si.ft"~T
<br />Address of owner: (No. am S"creet~ (City)
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<br />R o.5ew.:od. C \)' f\~' 4. i '---'V
<br />(Name of Applicant): (First) (Mitme)
<br />I J /,Jl'J t- (O~''''I1"' R S..... ]00 ft-v!(' ".:ai
<br />(Address of AppL): (NO. ard street) (City) (
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<br />;)5.;2$ S'l\e'L~ G Av~. ).)0,
<br />St1:eet Address of Property Involved:
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<br />(last) (Iba1e)
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<br />(~) (Zip)
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<br />(last:)
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<br />5.
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<br />6. O:i\1;Ilete Isgal Descrjptian of ~ Involved: At1^LI...f',(
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<br />7. Date ~ Acquired: 11 ~ q
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<br />Present Use of Pcopaty: VI'\(....f\1 9. Present Zan.iIq cf PropP.rty: R- I
<br />Proposed Use of Property: F..,^,t"'i ~~...ef!.. PrqJosed Zoning ,:)f Property:-:a:=:::L
<br />V'\~tl 1~ ~
<br />Present O:I:prehensive Plan Desiqnaticn:
<br />Proposed catpTehenslve Plan Designation:
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<br />~t plan or ct\ange' makEs this request necessary? e.. ....It'e, t 2. \..'I.~
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<br />~t is the exr~ effect of the prqxJSE!d d\arqe? (For exanple, an property
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