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E. ! <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />g <br />Rezoning <br />Special Use Permit $100 Division of Platted Lot <br />Vacation of Right -of -Way $100 Relocation of Dwelling $50 <br />Preliminary and Final Plat Variance to Zoning Ordinance $50 <br />$100 Minor Variance g $25 <br />Please complete form by typing or - $25 <br />use additional sheets, keying information printing in If the spaces p provided are insuffi cien <br />he proper item numbers. <br />1. L Oki <br />Name of <br />Owner: first (Middle) <br />(Las (L <br />2• 3 g 3 ? (Phone) <br />Address of Owner: ��e and <br />(No, and Street) .(`City) �S <br />3. /� (State) (zip) <br />Name of Applicant: (First) <br />4. (Phone) <br />Address of Applicant . <br />" (No, and Street (City) (State <br />5' ? 4 D_r CTd) (zip) <br />Street Address. of Property Involved ��' J�c•--� %,�'� <br />Its , <br />6. Complete legal description of propertinvolved: <br />7. Date Property Acquired:, <br />8. Present Use of Property: <br />Proposed Use of Property: <br />9. Present Zoning of Property: % <br />Proposed Zoning of Property: <br />10. { at plan or change makes this p�p�vr.equest necessary? p0 ski -- <br />R s . . Co;-,-, PA <br />11. What is the expected effect of the proposed change? (For e <br />health, safety, parking, traffic conditions, etc.) example, on property p P rtY values, <br />na 6 t 5 o R E'° _ram S R0 P —le <br />r9 <br />