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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 - $45 <br />(All fees payable upon submittal of completed application) <br /> <br />Applicants are responsible for placing a City provided "NOTICE OF LAND USE ACTION" sign on the subject <br />property at least 10 days prior to the scheduled hearing before the Planning Commission or City Council. <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: -p~. (o,,"<')\-~()2--lOqS-O <br /> <br />1. Name of Owner: (First) (Middle) (Last) (Phone) <br /> <br />2. <br /> <br />Address of Owner: (No. And Street) <br /> <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />3. <br /> <br />~;o G.~/~(;>J <br />Name of Applicant: (First) <br /> <br />$""')1, <br />(Middle) <br /> <br />~iJ (t,-t- v11 UA; <br />(Last) <br /> <br />/J1 ~ J:;;-/I j' <br />(Phone) <br /> <br />4. <br /> <br />r/11/cJ/ A k L -7/.) tV AJ <br />Address of Applicant: (No. And Street) (City) <br /> <br />.()>('v'/5 <br />(State) <br /> <br />(',SZr L{81' cPf 3tf <br />(Zip) <br /> <br />5. Street Address of Property Involved: <br /> <br /> <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 />f'&o/bxf<J <br /> <br /> <br /> <br />tv /m lIausE tt IJ/!-J vi (/J/IJ'1 . <br /> <br />Page 1 of2 <br />