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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 _ Division of Platted Lot $50 <br />Special Use Permit $100 _ Relocation of Dwelling $50 <br />_ Vacation of Right -of --Way $100 _ Variance to Zoning Ordinance $50 <br />_ Preliminary and Final Plat $100 Minor Variance $25 <br />Please c^replete 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. IfOG, <br />Name of Ovier : <br />2. <br />Address of Owner: <br />3. o <br />Name of App cant: <br />(First) (Middle <br />.0 ✓ C? <br />(No and Street) <br />"e -XIle <br />(First) (Midd <br />4. 1 02r7a "y V ,, <br />Address of Applicant: <br />e <br />(No. and Street) <br />Street Address of Property Involved: <br />ff W I—AFZ- �-d y--?; <br />(Last) (Phone) <br />City) (State) (Zip) <br />(Last) <br />(City) <br />(Phone) <br />(State) (Zip) <br />6. Complete Legal Descyy// <br />ry�ipt' on of Property Involved: J= ZY <br />�ec�� % <br />7. Date Property Acquired: <br />8. <br />9. <br />10. <br />11. <br />Present Use of Property: Proposed Use of Property: <br />Present Zoning of Property: Proposed Zoning of Property: <br />What plan or�change r makes this request necessary? <br />_�� //DJ! v/�/�_ _ � !►/�sy JJS-.ram r"- .ii.� � �l � � ��� � ��,�� <br />What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc,.) <br />