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'RO <br />d CP.n�U•. ` i <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />$100 <br />Division of Platted Lot <br />$50 <br />Rezor.�ng <br />Special Use Permit <br />p <br />— <br />$100 <br />Relocation of Dwelling $50 <br />Variance to Zoning Ordinance $50 <br />_ Vacation of Right -of -Way <br />Final Plat <br />$100 <br />$100 <br />Minor Variance <br />$25 <br />Preliminary and <br />_ <br />Please complete form by typing in <br />or printing in ink. If the spaces <br />keying information to the <br />provided <br />proper <br />are insufficient, use additional sheets, <br />item numbers: <br />1. <br />Nam of Owner: (First) <br />2. <br />3. <br />4. <br />5. <br />Address of Owner: <br />Name of Applicant: <br />e) <br />No. and Street) (City) <br />First) (Middle) <br />ress of Applicant: (No. and Street <br />Street <br />ress of Property Involved: <br />(Last) <br />(Last) <br />City) (State) <br />6. Complete Legal Description of Property Involved: <br />(Phone) <br />� rltvii�, <br />(Zip) <br />7. Date Property Acquired: e <br />8. Present Use of Property: <br />Proposed Use of Property: <br />9. Present Zoning of Property: ' Proposed Zoning of Property:$__ <br />10. What plan or change makes this request necessary? D�`ft�� <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />