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<br /> <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 - $45 <br />(All fees payable upon submittal of completed application) <br /> <br />Applicants are responsible for placing a City provided "NOTICE OF LAND USE ACTION" sign on the subject <br />propeliy at least 10 days prior to the scheduled hearing before the Planning Commission or City Council. <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br /> <br />1. <br /> <br />Name of Owner: <br /> <br />(First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />2. <br /> <br />;:;~1T ~ld <br />Address of Owner: (No. And Street) <br /> <br />/ tp / '1 >t'\..eA'I~1 Sr; {AJ, <br />Name of Applicant: (First) <br /> <br />?~'tr,^V\f\.,) <br />(City) (State) <br /> <br />J;~/'Ik /17~ <br />(Middle) (Last) <br /> <br />0S~J - 3Q8..66)) <br />(Zip) <br /> <br />5$//3 <br />(Phone) <br /> <br />3. <br /> <br />4. <br /> <br />5~ ,[,:l:w!e.) 5c...vt.-/GtW/lI' <br />Address of Applicant: (No. And Street) (City) <br /> <br />/t>1 ??te..//'~ ;;: h). <br />Street Address of Property Involved: <br /> <br />?s-/-3.7'~ <br />(State) (Zip) <br />551 /.s <br /> <br /> <br />5. <br /> <br /> <br />~~e- <br />6. Complete Legal Description of Property Involved & PID No. (below or attached): <br /> <br />t~r /$ 8/1{, ( <br /> <br />/-)c:trYlm - II-e-~ //0, <br /> <br />7. State exactly what is intended to be done on or with the property that requires the conditional <br /> <br /> <br /> <br />i?&-M <;Jbb~ ;117i:j) <br /> <br />Page 1 of2 <br />