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i <br />4 <br />• <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />� <br />_ Rezoning $100 _ Division of Platted Lot <br />_ Special Use Permit $100 Relocation of Dwelling $50 <br />� Vacation of Right-of-Way $100 ariance to Zoning Ordinance $50 <br />_ Preliminary and Final Plat $100 <br />Minor Variance �25 <br />Please complete form by typing or printing in ink. If the s aces <br />are i,nsufficient, use additional sheets, keying information to theProvided <br />item numbers: proper <br />1. <br />Name of Owner: <br />c�'�� �. <br />(First) <br />2 . c� � (p (Q �=,�`��f` V �►� 'i� <br />Address of Owner: (No. <br />3. <br />Name of Applicant: ( <br />4 . 4�J � �aN�� <br />Address of Applicant: <br />First) <br />�� <br />(No. <br />Midd�e ) <br />��SC�'� ��! +�. <br />Street) (City) <br />- d �� ` <br />(Middle) <br />��� � <br />Street) (City, <br />5. a��� F�`�rv'►e�� A�. _ <br />Stre�t Address of Property Involved: <br />6. Compl te Leg 1 Desc iption of Property Involved: <br />� t�c� �.����C�,� t71 n..l-.-►.1_ cl <br />7. <br />8. <br />9. <br />10. <br />� <br />Date Property Acquired: <br />(Last) - <br />'� � . <br />(State) <br />,�� � <br />(Last) <br />��j A (�C <br />( S�.ate ) <br />� 3� --C�`fl. <br />(Phone) <br />.� �1 � <br />(Zip) <br />(Phone <br />Zip <br />Present Use of Property: Proposed Use of Property: <br />Present Zoning of Property: �-� Proposed Zoning of Property: <br />What plan or change makes this request necessary? � � ��� � <br />���_ �j � � <br />''� ��� �.Dr�� � � <br />ti <br />s,�- ,�.— �.-5� � t� � c�n . e.� \ �C1.. 4�. 5 i � i r.1 � � rv, � �� ,r�.s ��. e ..� ,. _ �'--- <br />�, o��U i�� <br />'�o� � ��,,x.e_�c�'\. w� t�-a! R � � C, � �r �. �� .r �~ `' ► `� �,c v,� <br />:e <br />�, p v.;r �p���S � i�-.i <br />11. Whatis he e p cted effect of the <br />p r o p e r t y v� l u e s, h e a l t h s a fe t proposed change? (Fo r e x a m p l e, o n <br />����� � y, par. king, traffic conditions, etc. ) <br />