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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />Rezoning $100 <br />Special Use Permit $100 <br />Vacation of Right -of -Way $100 <br />Preliminary and Final Plat $100 <br />Division of Platted Lot $50 <br />Relocation of Dwelling $50 <br />Variance to Zoning Ordinance $50 <br />Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to the proper item numbers. <br />1. ly/// ,)"iyiuv-, 09 <br />Name of Owner: (First) (Middle (Last) (Phone) <br />2 . J 0.' <br />Address of Owner: <br />3. (" So N`7 '.� C� c (e. <br />Name of Applicant: <br />V /J <br />(No. and Street <br />4. <br />Address of Applicant: <br />Street Address of Pro <br />(�Z-'j /,1-, 0 <br />L rs�—t ) i <br />No. an <br />erty In <br />:" <br />treet <br />1 ve <br />IZ51p() e 6-- 1 //1"-01 <br />(City) (State) (Zip) <br />.ddle (Last) (Phone) <br />(City) State (Zip) <br />6. Complete legal description of property involved: 'Ca%` '`q <br />l3 [ oc& / <br />h�CAL-i/ 0abk73 0 <br />� J <br />7.�Date Property Acquired: <br />8. Present Use of Property: S'1*41:1- �,.,,1 �j Proposed Use of Property: <br />9, Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan/ or change makes this request necessary? r v r,, - <br />(d ;l Z)4 fy c cv,i �iG Iy / ;!� f" fr ,7 2i . , .fir, { <br />l� <br />11. What is the expected effect of the proposed change? (For example, on property values, <br />health, safety, parking, traffic conditions, etc.) <br />