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,�PE�IAL_L�S� PE.R��T <br />• .�AF'PL�CA7IOi�1 rQ� �FECT�PE��IIT <br />. <br />• UNDII� THE ZONI2�JG ORD?::�.,�� <br />Fee: �.00 �/�s3ZZ <br />� a�se—No.: <br />VILLAGE OF Rt,tiSEVILL�;, �ilNi�r.�SOTA Routing: <br />I.D. Cler�: <br />�ldg. Insp. <br />Attorney <br />Directions: FiI1 out this form in duplicate hy typin� or � Engineer <br />printing in ink. If the spaces provided are insuff'icient, V. Adr.ii.n. <br />us� additionai sheets, keying informaiion to the proper <br />�tem nwnber. <br />` 1. Name oi Applicant: Last first middle <br />� .$. �: t�illmu� Prop�rtiea Yria. ancl �I�i�garet 3trong � <br />�., !�ddress of App icant: No. and streeL city and zone staia <br />�242� We�t Co R�. C� S�� P�ul I�i�u'�: <br />;�:._....._...� <br />: �; ;1�:c�e of Owner: last first mi.ddle <br />� <br />S SmA <br />'�. Addres� pf Owner: no and street city and zone state - - <br />'$ �118 <br />„;;. <br />� St,reet Addr�ss of Property Involved: . <br />�:ti <br />���1x�.ng Ave. betw+�ex� �2 and I�y��.s <br />�; � . `Legal Descrip�.on of Property Involved: <br />F`. - �v�enill� T'e�r�ae .p�at 1� bl.aczk lf I.o�a �.�� lb 1?� 18�: ���;' ��� <br />� ��7. 'Present Zoning stric . . on�.n ce e ion � � <br />� Authorizing Special Permit: ;# <br />�:, <br />_ :;; <br />B � ' $ • ��itJ , r, <br />� <br />��i' .. .:' 9.. :'Present Use Qf_ Property: 10. Proposed Use of Prop�erty <br />;:: <br />y. <br />.' 17..: D"escri�ption of Request: <br />'' Wri�ten statement on proposed use of property. (2 copies) <br />-', - <br />��' P�.an.�ed res�.��r�tial (5 uni�� <br />r�` P1an of proposed developmen� copies <br />`� ': 12. inihat wi:11 b�; the effect of the proposed use on the health, safety, and welfare of <br />accupants of surrounding lan�s? <br />l�c� adv�r�e affe�t . <br />;, 13.`;' What �ta.11 be the effect on existing and anticipated traf'fic conditioris, �including <br />; pa.xking facalities on adjacer�t streets? <br />,,�'O ad'�►0�8� �fPee� <br />-'' �.: .What wa.11 be the ef'fect on property values in the surrounding area? _ <br />�a aci�r�rse aPfea� <br />,� 1.. At�knowledgment and Signature: The undersigned hereby represents upon all of the <br />penalties of law, for the purpost of ir�ducing the Village of Roseville ta take the <br />�.cti.on herein requested, ihat all statements herein are true and that all work <br />herein:mentioned will be done ir� accordance with the ordin�nces of the Village of <br />_ RoseviTle, , and the laws of the State of Minnesota <br />��� ������ - <br />,, <br />Date .�� �';/�� - G- ti` Signature . , <br />_ � <br />