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1 <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 />Rezoning $100 <br />Special Use Permit $100 <br />_ acation of Right -of -Way $100 <br />_ Preliminary and Final Plat $100 <br />_ Division of Platted Lot $50 <br />Relocation of Dwelling $50 <br />_ Variance to Zoning Ordinance $50 <br />_ Minor Variance $25 <br />Please complete form by typing or printing .1-n ink. If the spaces provided <br />are insufficient, use additional sheets, ke,,,,'.ng information to the proper <br />item numbers: <br />1. <br />Scott W. Roberts <br />631-9113 <br />Name of Owner: (First) <br />(Middle) (Last) (Phone) <br />2. <br />2465 No. Fairview <br />Roseville Minnesota SS113 <br />Address of Owner: (No. and <br />Street) (City) (State) (Zip) <br />3. <br />City of Roseville Parks and Recreation Department 490-2280 <br />Name of Applicant: (First) <br />(Middle) (Last) (Phone) <br />4. <br />1114 Woodhill Drive <br />Roseville Minnesota 55113 <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. <br />1969.W. County Road C2 <br />Street Address of Property Involved: <br />6. <br />Complete Legal Description of <br />Property Involved: <br />Langton Lake Industrial Park <br />subject to drive easement, 0 2, Block <br />.7. <br />Date Property Acquired: <br />