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• <br />U <br />CITY OF ROSEVILLE <br />2660 Civa,: Center Drive <br />Roseville, L1innesota 55113 <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 5550 <br />_ Variance to Zoning Ordinance $50 <br />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. <br />2. <br />3. <br />4. <br />Name of Owner: <br />ss of Owner: <br />Name of Applicant: <br />(First <br />Address; of Applicant: <br />rV <br />Middle) <br />No. and Street) <br />First) (Middle) <br />(Last) (Phone) <br />(City) (State) (Zip; <br />(No. and Street) (City <br />Street Address of Property Involved: <br />(Last) (Phone <br />(State) (Zip) <br />6. Complete Legal Description_ of Propertty Involved: 407- � �, x�` 411 <br />10 <br />7. Date Property Acquired: <br />8. Present Use of Property: 7xProposed Use of Property: <br />9. Present Zoning of Property:_ Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, r.ealth, safety, parking, traffic conditions, etc,) <br />