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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 <br />$50 <br />_ <br />Special Use Permit $100 _ Relocation of Dwelling <br />$50 <br />_ <br />Vacation of Right -of -Way $100 _ Variance to Zoning <br />Ordinance <br />$50 <br />_ <br />Preliminary and Final Plat $100 Minor Variance <br />$25 <br />Please complete form by typing or printing in ink. If the <br />spaces <br />provided <br />are insufficient, use additional sheets, keying information <br />to the <br />proper <br />item numbers: <br />1. J&ff <br />489 - 1736 <br />Name of Owner: (First) (Middle) (Last) <br />(Phone) <br />2 . 4s / So W CC.44,enN 13 c.Va. ; 46Se o 1"r <br />SS/ 13 <br />Address of Owner: (No. and Street) (City) (State) <br />.(Zip) <br />3. 6Eog-6E w. jo Ht4-60N_ <br />��9-2-736 <br />Name of Applicant: (First) (Middle) (Last) <br />(Phone) <br />4 . $5 I SZ)M (� Cg Q2o N t?I-VD e0s EV1 L& <br />141v • <br />SJ 1 / 3 <br />Address of Applicant: (No. and Street) (City) <br />(State) <br />(Zip) <br />5. 4-S/ Sa M c C d P-X�an/ gLVD f�a s c ✓/crc c o�? nr <br />. <br />Street Address of Property Involved: <br />6. Complete Legal Description of Property Involved: <br />_ <br />r G <br />�- <br />7. Date Property Acquired: JUL l 9 S$ <br />.SJNGLC <br />8. Present Use of Property: jee ,j O Proposed Use of Property: KeS i DENCE <br />9. Present Zoning of Property: FA$J..PW6 Proposed Zoning of Property: s" � <br />FAA- t L <br />10. What plan or change makes this request necessary? <br />-PQ4r4 To Gc7N �t2✓� 7 S�'e4Sa1.1 ,Pl�2GK ��,P�DY /s S` 2� U <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />j/!ROV IOC 6ETTE-R S12a1�1ER L/t%//YG -41e64 <br />