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�7 y <br />V <br />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 -� Division of Platted Lot <br />Special Use Permit $100 <br />$50 <br />of Right -of -Way $100 ---_ Relocation of Dwelling <br />$50 <br />.Vacation <br />Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 Minor Variance <br />$25 <br />Please complete form by typing or printing in ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to <br />the proper item numbers. <br />1. p-&-- / i <br />ame of Owner: (First) (Middle) ) Last) _ <br />(Phone) <br />2. c.� Z` <br />Address of Owner: (No, and Street <br />(CitY) (State) <br />(Zip) <br />3. .�;2?owlr <br />Name of Applicant: (First) (Middle) (Last) ) <br />(Phone) <br />4. <br />Address o pplicant: (No, and Street (City) (State) <br />(Zip) <br />5 . Gj . <br />Street Address. of Property Involved <br />6. Complete legal description of property involved: <br />7. Date Property Acquired: <br />8. Present Use of Property: Proposed Use of Property: <br />9. Present Zoning o.° Property: Proposed Zoning of Property: <br />Y <br />10. What plan or change makes this request necessary?—� <br />11. What is the expected effect of the proposed change? JZFor example, on property values, <br />health, safety, parking, traffic conditions, <br />etc.) <br />h <br />