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<br /> <br />J.! . <br /> <br />/ ' . <br />/:; - /i ~ ::f., <br /> <br />CITY OF ROSEVILLE <br />2660 CIVIC CENTER DRIVE <br />ROSE"VILLE, ~~OTA 55113 <br /> <br />Please d1eck it.i:!m or ite:m5 for ..'hien yw are awly:i.nq: <br /> <br />Pli'D $750 CcI:p~'1ensive Plan ~,t $750 <br />= RezaniJ'g $300 - Divisioo of Platted Lot $100 <br />__ Special Use Fennit $200 - Relcx:aticn oJf DoIP..llirg $100 <br />_ Vacatioo of Right-of-way $200 - Vari.aIx:e to ~.i.--g Ordi.-.an:::e $2J)O.., <br />_ PrelIDinax'y ani F.inal Plat $500 v SborP~ine ~t (~/' <br /> <br />Please calplete fmn by typirq or prirt"~ in ink. If the ~ pro-vided are <br />i."\SUfficient, use additiaral sheets, key~ infODliitian to the prqIer item ~: <br />; ''g ") J <br />1 1 :/"; 'I, ....! I~ 1/'- I j..f J - lilr:-Y <br />. ~'--~ L./' -' \....~{... "..1!:. c7" I \.00{ ).f) <br />Name of o.mer: (First) (Middle) (last) (Rn1e) <br />^ "'.' I ..-'} ".; s-::~ 14 ~ <br />'</7.-~} . I ' " rS, {i'!7 k'~,'-;:" {I,!_, :'-'ff! "1/ / <br />.....) ~ I V L-.v' (j~, '"'_..) (,: l;;::.:;...A..-. . . -....r.,.:...),- 1f : l ; : IL/ - ~ .- ! 4 <br />Address of Owner: (No. am ::,"t.l:est) (City) (state) (Zip) <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br />6. <br /> <br />---= <br />7, <br /> <br />.5;'~.'L <br />(Nane of ~'lic.ant): (Firsti <br /> <br />(Midn~) <br /> <br />(last) <br /> <br />(Irone) <br /> <br />(Address of _~l.): (No. arc.: street) <br /> <br />(City; <br /> <br />(Zip) <br /> <br />(state) <br /> <br />,.-., <br />yn..e..- <br />Street Aclli'ess of "Pn:pet~ Involved: <br /> <br />Carplete ~ Desc::riptim of Prq>erty Involved: - <br /> <br />lBte Pt-cperty Ac.:juiJ:ed: <br /> <br />8. <br /> <br />Present Use of PtqJerty: <br />FropcseJ Use of l"rq:Jert'.i: <br /> <br />9. Present Zoning of ?rcJI:ert:y: <br />Prc:p:&...d Zcn1in:J of P!:q)&ty ~ <br /> <br />10. Present C::%Tprehensi,;-e Plan Designation: <br />I'::'::?-~ ~~,!'.5~."'? Pl ~T1 ~iqnatioo: <br /> <br />11. What pla.'1 or c::han3e makes tt.is request ne..,-essary? <br /> <br />12. w1'lat is t.'le t'>~ effect ;)f the proposed change? (For exaJ:!)le, a."! ptqJerty <br />values, health, safety, park.in:J, traffic conti.tions, et:::.) <br /> <br />~.._~~ <br /> <br />~ ' <br />, " <br /> <br /> <br />