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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />-it nivz <br />Please check item or items for which you are applying: _4�71) ff_rllj <br />Rezoning $100 <br />_ Special 'Use Permit $100 <br />_ Vacation 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 in ink. If the spaces provided <br />are insufficient, use additional sheets, keying information to the proper <br />item numbers: Cv <br />Name of Owner. <br />2. ✓ - C/y- <br />AFirst) (Mi <br />Address of Owner: (No. and Street <br />le) <br />i <br />(City) <br />Name of Applicant: (First) ( Muddle ) <br />4. <br />Address of Applicant: (No. and Street) (City) <br />5. % 1 z2 6JL/I <br />Street Address of Property Involved: <br />6. <br />Complete Le al Description of Property Involved: <br />Last) (Phone) <br />t tate ) <br />(Last) <br />-6--5- /3 <br />(Zip) <br />(State) <br />(Phone) <br />.::YX/3 <br />IZip) <br />,_ v /s :�.3 ,t'11:v o;'y <br />7. <br />Date Property Acquired: <br />8. <br />Preoent Use of Property: <br />�,t,�,d�` Proposed Use <br />Property: 4 <br />/ of <br />9. <br />Present Zoning of Property: ' l Proposed Zoning <br />of Property: <br />10. <br />What plan or change makes <br />this request necessary? <br />AA <br />�'-/.� .9T.• i7 .emu//.� <br />TGvd �i�� 1��.� i`� _ <br />�iyr�r �; c..�irde�i��.� <br />2 <br />S'1f�lz_ <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />cell"- <br />