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r <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 s Division if 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 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. CLAe-EA2cLr A. �- DAJZL-EVE �. �L-C-k-e ) jQ. 4&4--6214 <br />Name of Owner: (First) (Middle) (Last) (Phone) <br />Address c,f Owner: (No. and Street) (City) (State) (Zip) <br />3. SAME <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br />4 . S A Mf _ — <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. 2$3a <br />Street A <br />FA221�J6 TO `T <br />ress of Property Involved: <br />6. Complete Legal Descri,�tion of Propet Involved: <br />_ L.,O'T �� , LCa� �� �F� B E 2T Lig S ' TE <br />7. Date Property Acquired: J AN �1-9 E.9 <br />8. Present Use of Property: Proposed Use of Property: <br />9. Present Zoning of Property: �_ Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />SEC TTA►CH EO : A <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />i <br />S L C A TTA c ig EO- IA <br />