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CITY OF ROSEVILLE <br />2660 Ci,,ic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />Rezoning $100 Division of Platted Lot $SO <br />Special Use Permit $100 Relocation of Dwelling $50 <br />Vacation of Right -of -Way $100 Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 _ Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided are insufficient, <br />use <br />_aaddd►itiional sheets, keying information to the proper item numbers. <br />1. <br />Name of Owner: (First) (Middle) <br />(Last) (Phone) <br />2. ARA.A160ood .j-,u_e_ Wojejj Ile, <br />Address of Owner: (No. and Street) City? (State) (Zip) <br />3.�� <br />Name of A <br />4. <br />Address o <br />5 e _. leg <br />Street Ad <br />6. C <br />scant: (First) (Middle) (Last) (Phone) <br />iI/e, os-j //. 'f <br />pplicant: No. anStreet) City (State) (Zip) <br />ress• of Property Involve <br />l9te legal desgription of property involved: <br />7. Date Property Acquired: -.el. <br />8. Present Use of Property: _QG Proposed Use of Property:, <br />9. Present Zoning of Property: SI.c1n A,,,(� Proposed Zoning of Property - AL ! ., <br />10. What plan or, change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on property values, <br />health, safety, parking, traffic conditions, etc.) <br />