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r <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />Rezoning <br />$100 <br />Division of Platted <br />Lot $50 <br />Special Use Permit <br />$100 <br />Relocation of Dwelling $50 <br />Vacation of Right -of -Way <br />$100 <br />Variance to Zoning <br />Ordinance $50 <br />Preliminary and Final Plat $100 <br />X_ Minor Variance <br />$25 <br />Please complete form by typing <br />or printing in <br />ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to the <br />pro er item numbers. <br />Name of'Owner: (First) <br />(Middle) <br />(Last) <br />(Phone) <br />2 . 7 <br />Address of Owner. (No. and <br />Street) <br />(City) (State) <br />(Zip) <br />3. <br />Name of A <br />4. <br />1 Address o <br />S. � <br />Street Ad <br />6. <br />5AA1 Z- <br />licant: (First <br />,pplicant : <br />/ ;� <br />ss• of Prc <br />No. and Street <br />g/Vs ��- <br />erty Involve <br />N <br />lete legal description of property involved: <br />ty) <br />ast <br />tate <br />one <br />ft <br />7. Date Property Acquired: Aloy, 4 A <br />8. Present Use of Property: Proposed Use of Property: <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. W���� Fj <br />h//atplan /o�r change makes <br />j this request ne:essary? � �f�. ,A <br />11. What is the expected effect of the proposed change? (For example, on property values, <br />health, safety, parking, traffic conditions, etc.) <br />-� f /f/hgiy°,/I <br />f" <br />