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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for <br />which you <br />are applying: <br />Rezoning <br />— Special Use Permit <br />$100 _. <br />Division of Platted Lot <br />$50 <br />_ Vacation of Right -of -Way <br />$100 — <br />Relocation of Dwelling <br />$50 <br />___. Preliminary and Final Plat <br />$100 <br />Variance to Zoning Ordinance <br />Minor Variance <br />$50 <br />_/ <br />$25 <br />Please complete form by typing <br />are insufficient, <br />or printing in k. If the <br />use additional sheets, <br />item numbers: <br />keying informationsto th <br />the <br />provided <br />proper <br />1. <br />2. <br />3. <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />Name of Owner: <br />Name o <br />Ur uwner: <br />Applicant: <br />7 S <br />ress of Applicant: <br />First ) <br />(Middle) (Last) (Phone <br />No. and Street ) (City) <br />(State) (Zip) <br />First) (Middle) (Last) <br />(Phone) <br />(No, and Street) (City) (State) <br />(Zip) <br />Street Address of�Property InvolvedPv�' <br />Complete Legal Descrint i nn -f <br />71 vo 44-� <br />Date Property Acquired: - S% <br />Present Use of Property: -,E,4_ proposed Use of Property: <br />Present Zoning of Property: —k_j— proposed Zoningof Pr operty:,V <br />What plan or change makes this request necessary? a �, <br />11. What is the expected effect of the proposed cha <br />(For example <br />property values, health, safety, parking, trafficeconditions, etc., )on <br />l !i <br />