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N <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />v <br />Please check item or items for which <br />you are applying: <br />Rezoning <br />Special Use Permit $100 Division of Platted <br />Vacation of Right-of-Way$100 ttll Lot $50 <br />$100 --- Relocation of Dwelling <br />Preliminary and Final Plat $100 — Variance to $50 <br />Minor Variance <br />Ordinance $50 <br />Please complete form by typing $25 <br />are insufficient, use addiionalrsheetsing in ink. <br />item numbers: keying If the spaces <br />Y� g information to the 1. proper <br />Name of Owner: 0�4 P+i1/L- <br />2. (First) (Middle <br />Address ..............f 3. (NOwner: � <br />o. and Street) <br />Name of Applicant: �- <br />(First) (Middle) <br />4. <br />Address of A 3 �OZ te 55 U <br />pPlcant: (No, and <br />5. so Street) <br />Street Address of Propertyiinvolved: ct o ,r <br />6. Complete Le al <br />!Last) (Phone) <br />( City) frlfv <br />(State) (Zip) <br />1 <br />(Last) ,,(Phone) <br />( City)ff- <br />-(Zip) <br />(Zip) <br />ption Of Pr <br />V05-S-1055 <br />�j- <br />� DescriopertY Involved: <br />St�R-3-e'e�- t <br />7. Date Property Acquired: <br />1 <br />8• Present Use of Property: <br />9• Present Zoning of Property: --g__%L___ Proposed Use of Property: <br />10. EEL— Proposed Zoning of Propert <br />What g makes plan or change Y ` <br />, this request necessary? <br />r� <br />�Y <br />11. What is the expected effect of the <br />Property values, health, safety, proposed change? <br />---ML_�Ec Y, piing, traffic (For example, on <br />conditions, etc.) <br />F [IL <br />Lc�E-,r> <br />