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cn,y OF pamvUE <br />2660 Civic CmIter Drive <br />Vie, Mi.rmesdta 55113 <br />Please check item or items for which you are applying: <br />comprehensive Plan Arencht m <br />_ Division of Platted Lot <br />Relocation of Dwelling <br />Variance to Zoning Ordinance <br />Shoreline Permit <br />PUD $750 <br />Rezoning $300 <br />Special Use Permit $200' <br />vacation of Right -of -lay $200 <br />Prelim and Final. Plat $500 <br />$750 <br />$100 <br />$100 <br />$200 <br />$ 50 <br />paces provided are <br />ink. If the s <br />Please complete form by typing or printirx� item numbers:insufficient, use additional sheets, ke',x�g y <br />information to the proper <br />REGORY S��BILD 778-1524 <br />1. G (First) (Middle) (Last) (Phone) <br />Name of Owner: <br />a.. -i_QI_Qwner;____(No.—and--Strmt).-- <br />3. w <br />(Phone) <br />=i• <br />4. (State) (Zip) <br />Address of Applicant:(No. and Street) (city) ( <br />5. in A e, SjjjtP 12.�� <br />nnQr� ri 11 e, Mi nne-sata 5511 <br />Street Address of Property Involved: <br />6. Camplete Legal Description of Property Involved: p l e a s e see A t t <br />7. Date propel, Acquired: Iie s e w i 1 t b e c om e e f f P c t'iv e as of 11- 01- 8 8 <br />9. present Zoning of Property: <br />S. Present Use of Property: _.__ proposed Zoning of Property: <br />Proposed Use of Property: <br />10. Present Comprehensive Plan Designation: <br />F.xoposed CoITrehensive plan Designation: <br />11. What plan or change makes this request necessary' <br />__ _9 TT - - -----4 t rorr Ili -rod fin Pstablish d faffi� 1� b� l l�r�l an� vi dPn <br />aamP ent <br />12. What is the expected effect of the Proposed change' (For exanmle, on property <br />values, health, safety, parking, traffic conditions, etc.) <br />None <br />