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4 <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive fi <br />Roseville, Minnesota 55113 �� V <br />Please check item or items for which you are applying: <br />Rezoning $100 _ Division of Platted Lot $50 <br />Special Use Permit $100 _ Relocation of Dwelling $50 <br />Vacation of Right -of -Way $100 Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 Minor Variance $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. <br />2. <br />3. <br />4. <br />5. <br />6. <br />Name of Owner: <br />ess of Owner: <br />Name of Applicant: <br />ress <br />Street <br />First) (Middle <br />S . m el I <br />No. and Street) <br />kmC <br />First <br />E <br />(Mi. <br />HppyiAicant: (No. and Street) <br />lV1.e-.Ceu.rVo�1s �tyd - <br />ess of Property Involved: <br />l uIry <br />4V'4-k -TV'. 4?y- <br />(Last) (Phone) <br />ZaSe-t); I le-, M n <br />(State) (Zip) <br />(Last) (Phone) <br />(State) (Zip) <br />Complete Legal Description of Property Involved: <br />.Ro l l o ti n 6rce N 4ma PY t"' . "A' I ,1 IR <br />7. <br />J <br />Date Property <br />Acquired: <br />`g <br />8. <br />Present Use of <br />Property: <br />Proposed Use of Property: <br />9. <br />Present Zoning <br />of Property: <br />Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />