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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 />Rezoning <br />$100 <br />Division of Platted Lot <br />$50 <br />Special Use Permit <br />$100 <br />—_ Relocation of Dwelling <br />$50 <br />Vacation of Right -of -Way <br />$100 <br />Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat <br />$100 <br />77— Minor Variance <br />$25 <br />Please complete form by typing or <br />printing in <br />ink. If the spaces provided are <br />insuffici <br />use additional sheets, keying information to <br />the proper item numbers. <br />1. <br />z. <br />Address of Owner: (No, and Street) <br />(City) <br />(State) <br />(Zip)3. <br />�R)Jllald /V/ I-Aa 4/ 1 i) - A- 1 <br />4-�6 <br />A /) e - te <br />JA3- <br />Name of Applicant: (First) <br />(11iddle) (Last) <br />(Phone) <br />��'�le. <br />NA <br />5l <br />Address of Applicant: (No, and Street <br />(City) <br />(State) <br />(Zip):: <br />5 . <br />A1611)( l 7 S <br />Street Address of Property Involved <br />6. <br />of pro`pfert invo/lved:Q181 <br />g7lete leg(a/l� % <br />")) - <br />' _v <br />ydescription <br />�1-.0ls� V <br />_ U0C,K1()()N <br />A l%,in/`1 <br />`Dit-I An.� <br />7. Date Property Acquired: <br />/ <br />8. Present Use of Property: ,IL4'/I j �`JSII.J PI��i'n % /1��6�'��J{t, Proposed Use of Property: <br />J <br />9. Present Zoning of Property: �0,,� �� Proposed Zoning of Property;]"f? <br />10. What plan or change makes this request necessary? �/Vaj <br />1 -U ' vCal d 2 <br />11. What is the expected effect of the proposed change? (For example, on pro erty values; <br />health, safety, parking, traffic conditions, etc.) <br />r7r pa,� <br />