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<br /> <br /> <br /> <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 790-7005 FAX: (651) 792-7070 <br />(City Code is available on the Internet: www.ci.roseville.mn.us) <br /> <br />INTERIM USE PER1VIIT APPLICATION <br />(CITY CODE SECTION 1012.09) <br /> <br />o RESIDENTIAL PROPERTY OWNER FEE - $150 <br />o BUSINESSIINDUSTRIAL FEE - $250 <br />(All fees payable upon submittal of completed application) <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 /> <br />(Phone) <br /> <br />2. <br /> <br />3. <br /> <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br />4. <br /> <br /> <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. Street Address of Property Involved: <br /> <br /> <br />6. 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 interim use <br /> <br /> <br /> <br /> <br /> <br />Page 1 of2 <br />