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SA'EC IAL t1SE PEitAlI T <br />APPLICATIt�I �R SPECIAL �ER'�!1T <br />t�D�ER Tti� 2t};�iNC ORll1ti�tiCE <br />YILLAGE 0� ROSEVILLE� h4IN�*J�St�TA <br />Fee. S10OAOQ <br />Case 'do. : <br />.�....�..._._ <br />rect ons: out t 2s orm in up cate y typ n� or printing in n. t e spaces <br />provided 4ro insufficic�nt� use mdditiongl, sheets� keyin� infor�,ation to th� <br />propar ite� numbarp <br />1. ' � , �/��� <br />�me o pp cant: ast <br />z. �7� � <br />x�o s s o pp c ar� t: ., "�'i�o <br />3. <br />"' ame o <br />a. <br />�c r� i� <br />S. <br />traot <br />�. <br />7. <br />8. <br />9. <br />10. <br />gel UOSC <br />r: <br />er: <br />so <br />�'/L1, <br />as� <br />���icG C <br />o. an <br />.��X/�t�JG T <br />roperty nvo v <br />(wirsc� <br />L w� ��, d . L <br />itI'80t 1 y► <br />� e..�..�_....,. <br />rst <br />SLrest) <br />�J �UE <br />Giv�-ti a�v � <br />n o roperty n v� : <br />��/�/�S"'/,,,/� = <br />CO���Zip <br />J <br />v�G u�J.n1 � <br />�C �� <br />Prassnt Zoning District ; �, �, <br />Zoning Ordinance Soction Authorizing Spocial Permit: g, ��� <br />— _ <br />Present Use Of P�operty : ���',(� ,�j�S]' �',� f�SDN ���$�ig-'i Cj C.�,(J� <br />Praposed Use Of P�ope�ty: T��¢C'N/,� �; v�� Sh�//itJ,�'�,��e.�� <br />11. Dsscription of Roquest: <br />�j j��a-„� written statement on proposed use of property (2 copies) <br />�����y+'�� Pla� of propose� dev�.l.9p�nt (5 copies) <br />12a What wil.l be the �ffect of the proposed use o�a the healthQ safety� and welf�re of <br />occupants of surrounding lands? <br />� o,��_ <br />13. What will be the effect on existing and anticipated traffic cor�ditions, including <br />p�rking facilities on adja�c�nt st�ests? <br />P� <br />(� C <br />.... --- --- <br />