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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 />g <br />Rezoning $100 <br />Special Use Permit $100 Division of Platted Lot $SO <br />Vacation of Right -of -Way $100 Relocation of Dwelling $SO <br />Preliminary and Final Plat $100 — Variance to Zoning Ordinance $50 <br />Minor Variance <br />Please complete form b typing or printing in ink $25 <br />use additional sheets, ykeyingginformation to theproperthe s aces <br />' P provided are insufficien. <br />item numbers. <br />Name of F 2 <br />- Owner: (First) (Middle) � "3 <br />(Last) (Phone) <br />2'h1'2Ste, 2 n AV � Iv <br />Address of Owner: (No. and Street <br />(City) (State) ' <br />3. (Zip) <br />Name ofpp cant A <br />li: (First) (Middle) <br />4. {Last) (Phone) <br />Address of Applicant3 o,�s�e2n <br />( nd Street)o �J <br />5• (City) (State) <br />A�� (Zip) <br />Street Aress• perry Invvoolvveded of Pro a 1�� !vo <br />aSa V t <br />dd <br />6. Complete legal description of property involved: <br />O 1'1 <br />7. Date Property Acquired: <br />R. Present Use of Property: ` .. <br />—��s Proposed Use of Property: <br />rty; <br />Present Zoning of Property; <br />Q d e'►laj' _. Proposed Zoning of Property; es <br />10. What plan or change makes this request necessary? <br />t-1 n _fI Lc L 1 e^— i <br />11 • What is the expected effect of the proposed change? (For exam e <br />health, safety, parking, traffic conditions, etc.) pl on property values, <br />