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s <br />w <br />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 <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 <br />$50 <br />Preliminary and Final Plat <br />$100 <br />_ <br />_,,y Minor Variance <br />$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. AA1,09)5W JrOHAI I-) /f 't) Lo IFO)v 6r rol Z) <br />Name of Owner: (First) (Middle) (Last) (Phone) <br />2 . 3 o W657-__�G o, RD, 1), /r aS Ir/c.� ' M I A//V <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />3. <br />Name of Applicant: (First) (Middle) (Last) -(Phone) <br />4. /?3o VVL:5-57�Go, 1 b, b, /?OSM//V/L)- <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. �30 W)5P RD D, DOSE(//(,t� , d�' /NA/ <br />Street Address of Property Involved: �-; <br />6. Complete Legal Description of Property Involved: Z-�/V- t/7r <br />�sT-WT- <br />I-o — Z BLocK / <br />7. Date Property Acquired: AloV /977 s <br />8. Present Use of Property: /dt'►�1� Proposed Use of Property: <br />9. Present Zoning of Property: �Sw nvthtroposed Zoning of Property: <br />10. What plaa-n or change G�ma es this request necessary? �yD�AI U/� <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />/pW / f(i �s� - — <br />