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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />_ <br />Rezoning $100 -Division of Platted Lot <br />Special Use Permit $100 <br />$50 <br />Relocation of Dwelling $50 <br />Vacation of Right -of -Way $100 Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 ..__..v Minor Variance <br />$25 <br />Please <br />use <br />complete form by typing or printing in ink. If the spaces provided are <br />additional sheets, keying information to the <br />insufficier, <br />proper item numbers. <br />1. <br />" N o r A'.vj-es� UV4 N <br />Name of Owner: (First) (,Middle) (Last) <br />(Phone) <br />2. <br />55 a5 <br />Address of Owner: (No. and Street) (City) (State) <br />(Zip) <br />3. <br />l (_.- _,_6c, <br />Name of Applicant: (Fi rs) (Middle) (Last) <br />(Phone) <br />AA i <br />Address of li` <br />Appcant: (No, and Street (City) ( ate <br />(Zip) <br />S. <br />DU <br />Street Add ess•of Property Involved <br />6. Complete legal( description of property involve <br />7. Date Property Acquired: <br />8. Present Use of Property: Proposed Use of Property:'�1N1 <br />9. Present Zoning of Property: Sko wg Cp,,,� Proposed Zoning of Property; <br />10. What plan or change makes this,r,equest necessary? � ��C��l <br />o <br />` <br />11. What is the expected effect of the proposed change? For example, on property values, hea th, jafet parking, traffic conditions, etc.) :r _(N,� ��S <br />O0 6 <br />