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<br />SpECIAL � PER'�ffT � Fee : ��. 00
<br />;AAPLICA�IOId FC?R 3P�CIAL PER1fIT Case No.: _
<br />~.ITr3DE��i ZHE ZONIPJG ORDINki�CE -
<br />VILLAGE QF RCSEVZL•LE, �ffN�iiESOTA Routing:
<br />I.D. Clerk
<br />_ Bldg. Insp. -.�._
<br />Attorney
<br />I?irectidns; Fill out this iorm in du�l�cate by typing or Engineer
<br />printing in .ink. ' If the spaces provided a.s•e ins•aff'icient, �T. Admin.
<br />usp add�tional sheets, keying informat-�on tc th� proper
<br />ztem nuinber.
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<br />1. N�.me` of 'APPlicant: I;ast �irst ma.ddle "�`
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<br />2. ',r�c�dx��s ;of Applicant. �o. and street city and: state _ J;�;y
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<br />; ,3. :; ��t m�:' of E?�mer: :last first ma.dd�,e ': ,;�;
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<br />� E �. ;; �treet Address of ` Property' nvo ved:
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<br />;:;;, } � rLeg escription af Property Invol.ved: ,+:,�
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<br />� . � > � Zonin Ordinance Section ' F �!
<br />A r�� , 7. Present _ 2oning Thstrict: . g ::
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<br />� , Autharizing Special Permit: ` ..4,:
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<br />.� :� 9,: Present Use of Propert,y: 10. Proposed Use of-Property
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<br />� � ; 11: Description"of Request: _ _ ; 5 ':,'�
<br />`' ' Written statement on proposed use o� property. (2 copies) '
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<br />�, ;Plan df propo�ed development (s copies) ' �'
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<br />:�.2 �;. What wi be the effect of t�.e proposed use on the" health, safety, and welfar;e of
<br />' occupants of surrounding l -�nds? �'�'�
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<br />13: Wha:t wi�l be t effe on exi.s�ing. and anticipated traf'fic conditions� incl.uding ;;'
<br />i , paxk�.ng facili ies on adjacent street5? , '��=:
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<br />�� . ll,be th� eff�ct on property values in the surr'oundin�; area? , {�'
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<br />` ; 1.; Acknowledgment and S'gnature: The undorsigned hereby represents upon a11 of'the� ;�
<br />'�s s penalties o:f 1aw, fox t�.he purpos� of inducing the Village of Roseville to take the ',��{�
<br />� ao�ion Yierea.n requested, tha�L all statements herein are true and that a17. work' ,.;; i
<br />'. herein mentioned tiaill be done �.n accordance with the ordinances of the Vi '� age of '�
<br />' Rosevill.e, and the l�ws of the State of Minnesota ,';�,;
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