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2/12/2016 3:33:09 PM
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t <br />� <br />� <br />SPSCIAL USF P'�II',T' <br />APFLIC,ATION F'Qft :6PIECIAL PEr'2�NIIT <br />U�tI'�i THE ZONTIN(3 t7RDI�1�S <br />VILI�AGE CF R05�VII►ZE, MIMrtESOTA <br />� <br />l�rectionss Fill out this form in duplicate by typing or <br />printing in ink. If the spaces provided are insufficient, <br />use additional sPzeets, keying i.nformation to the proper <br />item a�u�abe�� � <br />�� <br />� � <br />Fee: $25.00 � ltoi/ <br />Case No.: <br />Routing: <br />I. D. Clerk <br />B1dg. Insp. <br />Attorney <br />En�ineer <br />V. Admin. <br />. Name o�pp icant: I.a►st First Middle <br />��t�t <br />2. Address of Applicant: <br />!�t <br />. Name of Owner: <br />City <br />l�t, F�rttt �S <br />ta <br />�fi�� ++���e � <br />. Addres9 of Ow�er: No. F.nd Street City and Zone State <br />�i�� �il� �►��� <br />�. trest Address r�f Property : <br />� <br />�t. �E lf�l Ib <br />�. Legal Description of Propert�r Involved: �� ��p.� ��� ,� �+�t��+���� ��,�� � <br />�ar� +a�t �t }� y �►O�rM�#li� '�+i�r�►�i �� � � �aa�s� � t'�u�r �►� Ei�ilreo� +�i +�# lir�r�d <br />� � - �w� +r�s +.�wv� �w w..w � <br />�7. Present Zcinin� District: . 2oning Ordinance Section <br />Authorizing Specia.l Permit: <br />��i � . 8a�t�� i. �� C�lu ��� �It� �►a� t�. �ZA <br />9. Present Use of Property: 10. Proposed Use of Fraperty <br />�,x'�+'?� ��L� $0+� s�i��il a�t,ll�p� il�► ��L� E+ <br />11, Descrip�tion of Request: <br />Written st�tem�ent on propo�ed use of property. (2 c,opies). <br />Plan of pro�osed c��velopment (5 copies) , <br />� 1i�l�� M�►t�►�sA►t �!t �+� 8. <br />12�: T�at will be the effect of the proposed use on the health, safety, and �elfare of <br />_ occupants of surrounding lands? <br />� . <br />13. What will be the effect on existing and anticipated trzffic conditions, including <br />�parking facilities on adjacent streets? <br />.5`� . � � �. � � . ' .. <br />: <br />��F. <br />�' f . <br />
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