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CITY OF ROSE17ILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />Rezoning <br />$100 <br />_ Division of Platted Lot <br />$50 <br />Special Use Permit <br />$100 <br />Relocation of Dwelling <br />$50 <br />Vacation of Right -of -Way <br />$100 <br />Variance to Zoning Ordinance <br />$50 <br />_ <br />Preliminary and Final Plat <br />$100 <br />Minor Variance <br />$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 />Name of Owner: <br />Address of Owner: <br />RPP)5 FS <br />(First) (M <br />E? <br />Y AVE, 57, <br />(No. and Street) <br />Name of Applicant: ( First) (Middle!) <br />(Last) (Phone) <br />' u L 1v, ssi - <br />City) (State) (Zip) <br />(Last) (Phone) <br />4. It1� Au3 �J" �T; P/- OL MA) , Islo4 <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. ) 7 33 10, LEiX iAAS7? J A OaE , (L:EX11L)6-V,0 PL A zA <br />Street Address of Property Involviac' : <br />6. Complete Legal Description of Property Invol.ved: S6 C ATTAC a <br />7. Date Property Acquired: <br />8. Present Use of Property: e67A11- Proposed Use of Property: <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan or change maces this request necessa::y? <br />11. What is -,the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />