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3P��CI�.L !'�� PER�IIT <br />t::pPLa r�. i IUN r�R SPEC- PE:Z:��IT <br />.� � I�iDF�R THE ZONII`iG OR�I[��t.:�wCE <br />VILLtiC�E OF R.OSEVILLE, �`ilfvivESOTA <br />�'r� "�.UO _ <br />ase �10.: <br />� � <br />Directions : Fill out this form in �upll�'�:Lp �.�' ��� F" "r "' <br />P <br />rinting in ink. If' the spaces provided are ins�: f��o�'��«t, <br />use additional sheets, keyl.ng ini'orrna �l�n to t i p p <br />item number. <br />Narr��e �f Applicant : (Last ) <br />first <br />a�.rle�r Co���ru�t 9.an Ca. <br />� �treet) <br />12, `��.nne�ote. <br />2. ';�;ci.r�:s of Applic�.nt: (iVo. an <br />1$�3Q atow� , <br />._:.,:W _ _ . . .. __ ; <br />? '; , ;,;�� Qi C�wne r : <br />C���ley � <br />�t. ��.u1 <br />last � <br />Calvin �.nd. <br />Cleori <br />Rauting: <br />I.D. C1erk <br />Bldg� insp. <br />Attorney <br />�,n�ineer <br />V . Admin . <br />�ity anc zone <br />first <br />, ,,�^dress o:C Oz�mer: no and street) <br />�--: __ ; ; ��g,nn esot� <br />1G70 ��o�►�, �t. ��.ul 1.2 � <br />. <br />Stre�t Address of Property :�nvolv�a: <br />1�0 b]_ac�. on �lr:er ��r�e� <br />„ Leg <br />c:ity and zone <br />Description of Prop�rty Inv�lved: �h� 1�0° <br />I�at► 17� 'rYiarnton� �uba L��v�sion �F the <br />�~ Zoning c)rdinance Sec�tion <br />��uthorizir� 3pecial Permit: <br />13.130 <br />middle <br />str:te <br />midr]le <br />state <br />or the I�tcr�n ��v �✓1 <br />Nort� 1/�, Seation 13 <br />� Present on.in� T)i.st"rict: <br />j� � � <br />9, present Us� of Property: <br />�acant land <br />. <br />10, Proposed ilse of Pr•operty <br />�i� gox two 1? unit e�rt. blc��e. <br />� � /<f �. t n vrv �'1 � F2i I _ <br />�,1. Descriptian of' Request: (2 copzes) <br />Written �tatement on proposed u�e of property. y r � �� pne �1.c � <br />:�e re�ue�st �err�'���e��o� to bufl.d t�ro 2 7�/2 etor, e�,,,t� b�ld� <br />Plan of proposf�d development (5 cop��s) ^ <br />e L��hat will be the effect of the proposed use on <br />occupants of surrounding lands? <br />� �lv�ree ef�'�ct �hould ha�����n• <br />e health, safety, and weli-are <br />, o a, <br />13. <br />what wi11 be the eff'ect on ehs sting and anticipated trai'fic conditions, including <br />parking facilities on adjacent streets? �r,���,g' or 11 mor. e tk�an <br />Th�r� v�i � 1 be 61 par�in� e tall ��.nd �; . <br />�,�,� m nim m re uirements � undin area? <br />1, What will be the ef'fect on propert;�� values in the �urro � <br />It should inc <br />re�e t�1em aa the 1�.nd i� wild �.��d an eyesora �.t ��r�� e�� <br />Acknowledgment and Signature: The undersigned hereb�'laeerofeRosevplle�to takehthe <br />1 e the V11 � <br />penalties oi law, for the purpos= of inducing <br />action herein requested, that all statements herein aordinancesdof�theVillage of <br />herein mentioned will be done in accordance wlth the � <br />Roseville, and the laws of the State of i�Sinnesota �" <br />Jan. �2, �.96�+ Si�nature ����c'�"�� i���r'-�--- <br />Date <br />