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<br />CITY OF ROSEVILLE
<br />2660 CIv~C CENTEh DRIVE
<br />ROSEV:iT.T.R, MINNESOTA 55113
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<br />Flec..se chec..,: item or i1:S:'.;;. fo:: ..i1id1 you 3....'rE! ~lyi.:~:
<br />
<br />RJD
<br />- R?ZOI".l.N:;
<br />- SF~ial Use ?ennit
<br />Vacation of Right-of-way
<br />= PrelimL-.aty <3~ FirGl Plat
<br />
<br />$750
<br />$300
<br />$200
<br />$200
<br />$5GO
<br />
<br />~~ive Plan ~"Ia.~';:
<br />X: Divi~-ian of pla~t..Eri L:;t
<br />-~- :;clocaban vi Do1elling
<br />- "".'ari.an..'">So to Zc.n,ing Ordi.-,a,'1Ce
<br />Shcrci ire f"en.i t
<br />
<br />B50
<br />(~~l~O
<br />$10-C
<br />$200
<br />$ 50
<br />
<br />Please co:tplete form by typl.!'X} or printirq in ink, If tl1e spaces pID'.rideci ara
<br />i'1SUfficient, USE: additivnal s..~ts. keyl.n3 infoma~c.:"l to the PI"Oper item nU!!'bers:
<br />
<br />l.
<br />2.
<br />3.
<br />...
<br />4.
<br />5.
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<br />Lce ,-;"
<br />Nar.E of <A.--ner:
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<br />~~ ~I ~~ - S ._--; ir S'-
<br />(ft1one )
<br />..1111./ 5S- //3
<br />(Zip)
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<br />(~Q:1e)
<br />
<br />(Zip)
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<br />.:::.....1pleu;: ~ r:.escrip~ion
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<br />+4:' ~ I ....- v - .J ...;. "].J __. ! I '.r
<br />r~J'...,: {ic.. f ~!.; ...-t.1' (. \.~ -l'r
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<br />of ~q:><'....""t}, L'Wolved.; .~_::)= .....tJ.... i ,d' T ') '~, T/ ;."'! , r\i .:...
<br />-S::..:..~-r/; -.._r7{.- /J~~/~ ....-;.. ii..;7S I:.!.i l3 {if', is-,
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<br />___~____ __._ __~___ _~ .._______4_ ________._
<br />
<br />8.
<br />
<br />[~I
<br />P:"eSe.'1t USP- of ~..rt:y: _Ao_::i:' Ii.. 9. PJ:-.:>--_:;ej'\t Zor-:.irq of Prcpert-l: j'-'-
<br />1--1."'c+os€rl Use of Propel.ty: _t ~ ~q I:i l-iCF)]( ~ Zoni.TJg of ~per~y: _U_
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<br />~------ --
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<br />lC-.
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<br />Present Cc:'q:Jrel"1.=nsive PLu1 Desig;Bt,icn: ..i...L.'--"'- i,;'O.j.)~ i ;\( {i' -::,.!~T i!\1....-
<br />Pro!YJSErl c~rehensi\ie Plan D?.sigr~1tion: ~~iJ.~i'~\;11\J r'F'~-Ij)Fj...'Jj-A:C.
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<br />IL
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<br />~ddle)
<br />
<br />(last.)
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<br />~ ) ;,:1at is t.ne e');:pE\...'"tcd ",ffeGt of t.h.~ p~"€ri c.r~"'19t? (For e..'\.cl.J~pler 0:1 S:-ope1:y
<br />values, healtJ1, safety, par';irKJ, t...raffic conditions, ct.::,)
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<br />(First)
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<br />! ,-/ ~? '11-
<br />Addr~ of o..'!!er:
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<br />Ii. /-!~-:; I,i ~, j
<br />J j'j C ---' r-
<br />(No, a.-rl s~t) (City)
<br />
<br />/ ,_ .,' F
<br />. ....:-
<br />(~...ate)
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<br />!.,AtvJE
<br />(Name of AwHca."1t): (First)
<br />
<br />llll.iddl e}
<br />
<br />(I.a:,-t; )
<br />
<br /><- A~ff-
<br />{Addr\:)ss of Appl.) : (Nc. and Street)
<br />
<br />(City)
<br />
<br />{State}
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<br />j q - /4 .-'V i.-!::~ J-} i (i ;'~i (~..:._
<br />street Addrr'.ss of Property Involved:
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<br />7.
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<br />Date Prope...rt:y Acqt.lired:
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<br />i '--1 ~1-)
<br />
<br />n.
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<br />K~..'lt plil."1 or cr-..3.f\ge m:1ke.s this req-..:~-t: !1L"CeSSary?
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<br />I'~. ~ 1l....
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<br />-------'
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<br />----- ---- ---------~------------
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