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U, <br />• <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 />PUD $750 Comprehensive Plan Ame r1ment <br />$750 <br />Rezoning $300 Division of Platted Lot <br />-$100 <br />Special Use Permit $200 Relocation of Dwelling <br />$100 <br />Vacation of Right -of -Way $200 Variance to Zoning Ordinance <br />$200. <br />Prel i•n-.nary and Final Plat $500 Shoreline Permit <br />$ 50 <br />Please ooa�lete form by typing or printing in ink. If the spaces provided are <br />insufficient, use additional sheets, keying intormation to the proper item numbers: <br />Name of Owner: F�.?-st) (Middle) (last) <br />(Phone) <br />2. <br />Address of Owners (jdo+. and Street.) (City) (State) <br />(Zip) <br />3. <br />(Name of Applicant;): (First) Middle) (Last) <br />(Phone) <br />4. <br />(Address of Appl.): (No. and Street) (City) (State) <br />(Zip) <br />5. <br />Street Address of Property Involved: <br />, <br />6. Complete Legal Description of Property Imolved: <br />7. <br />8. <br />10. <br />12. <br />Date- Property Acquired: <br />Present Use of Property: 9. Present Zoning of Property: <br />Proposed Use of Property: Proposed Zoning of Property: <br />Present: Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br />-What plan or change makes this request necessary? <br />What is the expected effect of the proposed change? (For example, on property <br />values, health, safety, parking, traffic conditions, etc.) <br />