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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 <br />Special Use Permit <br />$100 <br />$100 _ <br />Division of Platted Lot <br />Relocation of Dwelling <br />$50 <br />$50 <br />$50 <br />Vacation of Right-of-way <br />$100 <br />Variance to Zoning Ordinance <br />Preliminary and Final Plat <br />_ <br />$100 — <br />Minor Variance <br />$25 <br />Please complete form by typing or printing in ink. If the spaces <br />keying information to the <br />provided <br />proper <br />are insuffii�-ient, use additional <br />sheets, <br />item numbers: <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />6. <br />9. <br />10. <br />/_V",A - 17f) Cr %/-,"� /N c . <br />Name of Owner: (First) (Middle) <br />4 pl?/e2 <br />Address of Owner: <br />/Zv 3b-✓a <br />Name of ,Applicant: <br />yC . /V 0/277- - <br />(No. and Street) (City) (State) (Zip) <br />(Phone) <br />(Last) <br />/201 V/1,c,-c- m <br />7i2 vR x _ _ 931-306 <br />(Middle) (Last) (Phone) <br />j5'al,l PAID /17 /Z /14i,, <br />re s of Applicant: (No. and Street) (City) I -- (State) (f,.Lv) <br />(First) <br />C"I" vA3 <br />Stre t A ress of roperty Involved: <br />Comple <br />Date Property Acquired: <br />Present Use of Property:oposeHd Use of Property: <br />P <br />Present Zoning of Property: Proposed 'Zoning of Property: WA <br />What plan o chawakes this request neceseoLk �-A^ark►? �� <br />Q <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />