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<br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, Mlt\i'NESOTA 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 />:8 BUSINESSIINDUSTRIAL 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. <br /> <br />Name of Owner: (First) (Middle) <br /> <br />Rc~~';\\~ ~d""-5+r\~ \l'<.\A.'~r, <br />Address of Owner: (No. And Street) (City) <br /> <br />4'10 0 V \ ~k, ''-'-0 tJ r: ~rt. f f cL ;':.,,,,, 1 M ~J <br />Name of Applicant: (First) (Middle) <br /> <br />)t? ~. ~ b,~ t,j iIY,..}Ll 0 lV', r ff'1"a~~ i <br />Address of ApplicanP. (No. And Street) (City) <br /> <br />(Last) (phone) <br /> <br /> <br />2. <br /> <br />(State) (Zip) <br />5'.)'1 S ~ <br />(Last) (phone) <br /> <br />o..~ ",.J <br />(SMte) , <br /> <br />A ttV\: ..J o~" <br />(Zip) <br /> <br />~4',"\^"" <br /> <br />s. <br /> <br />3. <br /> <br />4. <br /> <br />Sa.. ~__ <br />5. Street Address of Property Involved: <br /> <br /> <br />6. Complete Legal Description of Property Involved & PID No. (below or attached): <br /> <br />s~- A~,c.4J <br /> <br /> <br />7. State exactly what is intended to be done on or with the property that requires the conditional <br /> <br />use permit: .... . <br />~.- ') 5 v~ ,,- '-!l. 01 [LA P d ,.~ +'U l " s t (IV" , C;Y"'-4~J <br />u TJ <br /> <br />~5.o~ q,{J~ L:.J- k -\1-'tJ. ~ ~v:. f (c, if'-t4. h-~~ . <br /> <br />Page 1 of 2 <br />