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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 />Rezonin - $100 <br />>C Division ol. Platted Lot <br />$50 <br />$50 <br />Special Use Permit $100 <br />Vacation of Right -of -Way $100 <br />Relocatior. of Dwelling <br />Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 <br />_ <br />Minor Variance <br />$25 <br />Please complete form by typing or printing <br />in ink. If the spaces provided are <br />insufficient, <br />use additional sheets, keying information to the proper item numbers. <br />1. <br />Name a Owyler First) <br />e(Last)'(Phone) <br />41 <br />2. <br />Address of Owner: No. and Street <br />City (State) <br />(Zip) <br />3./ <br />Name of Applicant: (F-1rst) (Mi dle) ((Last) <br />(Phone) <br />4. <br />'& Z' <br />A ress o. Applicant: No. an txeet <br />City State) <br />(Zip) <br />5. <br />Street Address of Property Involved <br />. <br />6. <br />Complete legal description of property <br />involved: � <br />7. Date Property Acquired: ZL5—z1906 <br />_---- <br />8. Present Use of .Property:Proposed Use of Property: cTY"/C,f <br />3. Present Zoning of Property: - Proposed Zoning of Property: <br />- <br />10. What plan or change makes this request necessary?/✓/��'/GLC ��(d <br />11. What is the expected effect of the proposed change? (For example, on.property va ues, <br />health, safety, parking, traffic conditions, etc.) ZlAkjj� <br />..—,..T,.-.. .. . <br />