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CITY OF ROSEVILLE <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />Please check item or items for which you are applying <br />pUD <br />$750 <br />Comprehensive Plan Amendment <br />$750 <br />Rezoning <br />$300 <br />_ <br />Division of Platted Lot <br />$100 <br />Special Use <br />Permit $200 <br />-Way $200 <br />Relocation of Dwelling <br />Variance to Zoning Ordinance <br />$100 <br />$200 <br />Vacation of <br />preliminary <br />Fight -of <br />and Final <br />Plat $500 <br />Shoreline Permit <br />$ 50 <br />Please complete <br />form by <br />typing or <br />printing in .ink. If the spaces provided are <br />insufficient, use <br />additional sheets, <br />keying information to the proper item numbers: <br />c <br />T© N A/ -s,T. (//3 <br />iM 13311 <br />1. <br />Name of Owner: <br />(First) <br />(Middle) (last) <br />(Phone) <br />Ros .44 � M A/ <br />4 5/13 <br />2. J� i;� d.11 <br />Address of Owner: <br />�' <br />(No. and <br />, <br />Street) (City, (State) <br />(Zip) <br />3. (Last) (Phone) <br />(Name of Applicant): (First) (Middle) <br />4' (State) (Zip) <br />(Address of Appl.): (No. and Street) (City) <br />Street Address of Property Involved: <br />6. Complete Legal Description of Property Involved: <br />7. Date Property Acquired: V - A / <br />8. Present Use of Property: Present Zoning of Property: �, 5/b9 a t l A G <br />Proposed Use of Property: I? j5Si,,!7 .vtt 4,z Proposed Zoning of Property: S9 m_ <br />16. Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br />11. What plan or charge makes this request necessary? Z2 R t u L.D <br />,L1►,r�,�si,r�-- <br />12. What is <br />the expected <br />effect of the proposed change.? <br />(For example, on property <br />values, <br />& <br />health, <br />Ar- <br />safety, parking, traffic conditions, <br />etc.) <br />