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. <br />. s <br />t <br />CITY OF NEVI 7E <br />2660 Civic Center Dr" ve <br />RosevilleI 55113 <br />Please check item or items for which you are applying: <br />='rion <br />vlan Amendment of Platted Lot <br />Fel.ocation of Dwelling <br />Variance to Zoning ordinance <br />-- Shoreline Permit <br />$750 <br />PUD $300 <br />— Rezoning $200 <br />}{ Special Use permit <br />$200 <br />Vacation of Right-of-Way1 t $500 <br />$750 <br />$100 <br />$100 <br />$200 <br />$ 50 <br />-- l . and Fer al P a spaces provided are <br />Pre -in ink.If the spa P • <br />or printer, �item n�tbers . <br />Please Clete form by � information to the Proper <br />insufficient, use additional sheets, keying <br />T� <br />. . _: &-,I Darf nnr.ghio /T �ci-1 (rflone) <br />1• CPBP No. <br />Name of Owner: (First) <br />2• <br />10201 Wayzata i31vd.9 Suite 320 Address of Owner: (No. and Street) <br />inn <br />(Middle) <br />Minnetonka <br />(city) <br />3 • Woodbr!(Jgc t-ra ��� <<�0, ...- (Middle) <br />Name of Applicant: (First) <br />.z'M Minnetonka <br />55343 <br />(zip) <br />(Phone) <br />55343 <br />(zip) <br />10201 %Vayztlttr 01"? _ - (City) �.,...._ <br />4. lic.�nt: (No. and Street) <br />Address of APP M N 55113 _ <br />5. 3030-3050 Centre Pointe Drive <br />Roseville <br />Street Address of prop, y Involved: <br />(see attached) <br />6. �rPlete Legal Description of Property <br />Involved: <br />Acquired: ------�0 <br />.—. <br />7 • paste prop of Pr0P=tY: <br />Pro y • () 9 . l?reaen ZoningOf <br />ofor7erty: <br />present8. pret Use of per C;i}tt� ( trrc- Pr'°� <br />Proposed Use of Property • r <br />rehensive Plan ignation: <br />10.r�rive Plan �mt <br />sigion: <br />Proposed I ertsirr s lice to a 4'u!I service child <br />11. What plan or change rakes this r <br />eat nG-In— r � • ' <br />care provider, <br />(For exanVle, on proms <br />.Cted effect of the proPO change? I <br />12. 1'Jh.at is the tro f f is conditions, etc, j <br />valucy, health, sr"fete, parking, - -- <br />►�� rrr. <br />