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i <br />CrrY OF ROSE•VILL <br />2660 Civic Cm*A ' Drive <br />Roseville; Minnesota 55113 <br />Please :check item or items for which you are applying: <br />w#'O' PUD <br />$750 <br />Comprehensive Plan Amendment <br />$750 <br />Rezoning <br />$300 <br />Division of Platted Lot <br />$100 <br />Special. Use Permit <br />$200 <br />Relocation of Duelling <br />$100 <br />Vacation of Right -of -lay <br />$200 <br />✓ Variance to Zoning Ordinance <br />$200 <br />Preliminary and Final. Plat <br />$50015�lb <br />Shoreline Permit <br />$ 50 <br />Please complete fora by typing or printing in ink. If. the spaces provided are <br />insufficient, use additional sheets, keying information. to the item numbers: <br />16 Vf ��� <br />vxime of Owned (First) (Middle) (Last) (1,zone) <br />2. � r 4�cIILL _57 <br />Address of Owner: (No. and Street) (City) (State) (ip) <br />3. <br />4. <br />5. <br />Name of Applicant: <br />(Phone) <br />3/8 2- . }�Z Al 17 1, 1 MA/' <br />Address of Applicant:(No. and Street) (City) (State) (Zip) <br />yle_ 7?X 1?9-- v- Gov. <br />Street Address of Property Involved: <br />6. Cc uplete <br />lenx <br />7. <br />Date Property Acquired: _ lib -13 <br />•Present Use of Property: _j 9. ►Present Zoning of Property: <br />i/Proposed Use of Property:_- PVD Proposed Zoning of Property:�� <br />10.v'Present Comprehensive Plan Designation: <br />%Proposed Comprehensive Plan Designation- <br />11. What plan or <br />12. What is the expected effect of the prorosed change? (For example, on property <br />values, health, safety, parking, traffic conditions, etc.) — <br />