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CITY OF ROSEVILLE 2660 Civic Center Drive Roseville, Minnesota 5511.3 Please check item or items for which you are applying: Rezoning $100 V"Division of Platted Lot $50 _ Special Use Permit $100 Relocation of Dwelling $50 Vacation of Right -of -Way $100 — Variance to Zoning Ordinance $50 _ Preliminary and Final Plat $100 _ Minor Variance $25 Please complete form by typing or printing in ink. If the spaces provided are insufficient, use additional sheets, keying information to the proper item numbers: 1. ) A �� gg-V- c-�-7- Ho U-5, C (37c� --Q 7 72 Name of Owner: (First) (Middle) (Last) (Phone) 2 . /?9 S � W L.N- , 5 a... aQ S-Q, e , ,U sS-CL.? — Address of Owner: (No. and Street) (City) (State) (Zip) 3. J A Vv ��-�27 . Name of Applicant: (First) (Middle) (Last) (Phone) 4 . l F? S 92=- r - At, Sc- VcLLG- ! 4'A./t S S'l I Address of Applicant: (No. and Street) (City) (State) (Zip) 5. ( sa-w� L Street Address o Property Involved: 6. Complete Legal Description of Property Invollv�ed: -2 k- vk to uj-- -Q.tnj 6 C i 0-4- T �► r`Y,LRM C �J �Sy- _O-r jS�C7_ui�J m re" -(-4 f-RC wt j' t,--, , A xZ j-w-j A c re-$ +u f'�t (, x o� �i L ► ll:. C Sci� id L--t '1 `�'b 9 f a-L ,Jf` o'� 7. Date Property Acquired: /C?7 S- 8. Present Use of Property: Re,54eu,`,( Proposed Use of Property: S0' - 9. Present Zoning of Property: Proposed Zoning of Property: 5&" 10. What planorchange makes /jthis request necessary? 11. What is the expected effect of the proposed change? (For example, on property values, health, safety, parking, traffic conditions, etc.)