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0 <br />CITY OF ROSEVILLE <br />cb 2660 Civic Cei.ter Drive <br />Roseville, Minnesota 55113 <br />0 <br />Please check item or items for which you are applying: <br />Rezoning $100 <br />— Special Use Permit $100 <br />_ Vacation of Right -of -Way $100 <br />_ Preliminary and Final Plat $100 <br />a <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 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 />7. <br />8. <br />9. <br />10. <br />Name of Owner: (First) (Middle) (Last) (Phone) <br />1901 Po <br />s e <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />ITOME-s CO <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br />l yU / ICoS e't ou-.)h X Y P. v i %) e/ /VjJy !/ <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />Street Address of Property Involved: <br />Complete Legal Description of Property Involved: <br />Date Property Acquired: <br />Present Use of Property: Proposed Use of Property: <br />Present Zoning of Property: Proposed Zoning of Property: <br />What plan or change makes this request necessary? <br />-rhe <br />4, v n-� 4i-✓z b �-e S <br />What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />S �Y rev ti, 7 C CX-✓( <br />