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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 />_ Rezoning $100 _ Division of Platted Lot $50 <br />_ Special Use Permit $100 — Relocation of Dwelling $50 <br />_ Vacation of Right -of -Way $100 - Variance to Zoning Ordinance $50 <br />_ <br />_ Preliminary and Final Plat $100 Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided <br />are insufficient, use additional sheets, keying information to the proper <br />item numbers: <br />1- aUWAS <br />Name ,o Owner: (First) (Middle) (Last) (Phone) <br />2. Nsal ST-AL21 'enlv' suo <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />3. <br />4. <br />5. <br />6. <br />Name of Applicant:' (�st) (Middle) (Last) -(Phone) <br />Al17 __P4 C <br />e of Applicant: (No. and Street) (City) (State) (Zip) <br />P 7� e <br />Street Address of Property Involved: <br />Complete Legal Description of Property involved: <br />645L &Z f e7- o <br />._— .-^—,n •..-1 --.__ ini _ wn_._ nr A-V- -.. . j- ._ w.t^"._n �-.. ,_. �_I <br />.aPF=; P eo or Tim rpn; Doedk zA 1 .4.c>�(% rrir- <A.°-V C,,eJA 1'r"l- <br />7. Date Property Acquired:1,24 <br />8. <br />Present <br />Use of <br />Property: 167- <br />Proposed <br />Use of <br />Property: Lqm <br />9. <br />Present <br />Zoning <br />of Property: CS. <br />Proposed <br />Zoning <br />of Property: 9 <br />10. What <br />plan or change makes this request necessary? _, -; or CJ�ii^%A�t oe <br />too0a 1C'S/ 1 `` Ac t dloLg .C�ardt •- SCJU� AW c.9s?-Fi CeS. <br />11. What is the expected effect of the proposed change? (For example, on <br />property values., health, saf ty, parking, traffic conditions, etc.) <br />12 1y Q <br />01 <br />