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e <br />is i <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Plase check item or items for which you are applying: <br />e <br />_ Division of Platted Lot �50 <br />DV <br />Relocation of Dwelling <br />Variance to Zoning Ordinance $$20 <br />Minor Variance <br />Rezoning $100 <br />Special Use Permit $100 <br />_ Vacation of Right -of -Way $100 <br />Preliminary and Final Plat $100 <br />Ple <br />ase complete form by typing or printing in ink. If the spaces provided <br />are insufficient, use additional sheets, keying information to the grope <br />item numbers: ,! y <br />1. <br />2. <br />3. <br />4. <br />Name of Owner: <br />Address of Owner: <br />(First <br />Sao W <br />(No. a <br />Name of Applicant: <br />ess of Applicant: <br />(Middle) <br />nd Street) <br />First <br />'L, s 0 <br />(Last <br />v©Sulk-L&JYI <br />(City) (State <br />Q-V -It�' <br />(Middle) <br />(Last <br />' City) (State) <br />o. and Street) <br />5. n Is 02-Ib00e <br />Street Address of Property Involved: <br />6. <br />7. <br />8. <br />9. <br />10. <br />Complete Legal Description of Property Involved: <br />y . t _ „ i),. r -2 ni-kq i.�t, . ) b nn�� G D <br />551 l3 <br />(Zip) <br />(Phone) <br />(Zip) <br />Date Property Acquired: <br />49� U Proposed Use of Property: CQ-�r► <br />Present Use of Property: r,e_�� <br />�eS�cQyki6'roposed Zoning of Property:_P, <br />Present Zoning of Property: —_ <br />What plan or change makes this request necessLbL <br />? �� 0' 0-- �` Se�so� <br />7' Q0-nf-V- <br />o <br />11. What is the expected effect of the proposed rchange? <br />(Fo example, <br />xam le ,)on <br />property values, ,health, ^safety, parking, <br />