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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 />CONDITIONAL USE PERMIT APPLICATION <br />(CITY CODE SECTION 1013) <br /> <br />o RESIDENTIAL PROPERTY OWNER FEE - $150 <br />o BUSINESS/INDUSTRIAL FEE - $300 <br />o 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. Name of Owner: (First) (Middle) <br /> KN - <br />2. Address of Owner: (No. And Street) (City) <br />3. Name of Applicant: (Middle) <br /> <br />(Last) (Phone) <br /> <br />vA (..t^'lJ)/\JI'J <br />(State) <br /> <br />6'1 '7- q ILl <br />(Zip) <br /> <br />o <br /> <br /> <br />1\/1 <br />(Last) (Phone) <br /> <br /> <br />4. <br /> <br />Address of Applicant: (No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. Street Address of Property Involved: <br /> <br />6. Complete Legal Description of Property Involved & PID No. (below or attached): <br /> <br />7. State exactly what is intended to be done on or with the property that requires the conditional <br />use permit: <br />R6: <br /> <br /> <br />r;~ <br /> <br /> <br />,/V!, A Tc. ~ I /V <br /> <br /> <br />(J""JfE <br /> <br />A rvD {L6f'v(L <br /> <br /> <br />J t4E 0 <br /> <br />J-AJ <br /> <br /> <br />Jf <br /> <br />Page 1 of2 <br />