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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <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 tot $50 <br />Relocation of Dwe) rr:-; $50 <br />Variance to Zonis finance $50 <br />Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to the proper item numbers. <br />1. <br />Name o Owner: First <br />�GTDO <br />(Middle) Last (Phone) <br />2. <br />11-S% <br />6 <br />Address o Owner: No, and Street Cit/� <br />°�" Y) (State) (Z. <br />3. NORMRtH. —�--� <br />Name of Applicant: (Fixst <br />Mi dle Last <br />4. '' <br />fir' U JEk) <br />A ress o ppl3.cant : No. an treesI M <br />S. �(� ,� h ztY tate, <br />H iv Rbi B-a <br />Street dress of Property Inv <br />P Y olved <br />�6. <br />If <br />N <br />7. Date Property Acquired: ,D ) 0� �J <br />8. Present Use of Property: ��� �'� Proposed Use of Property: <br />9. Present Zoning of Property: <br />Ohl -Proposed Zoning of Property: <br />10. What plan or change makes this request nNTb�ecessary?C�IS.7r) Oc— <br />11. What is the expected effect of the proposed change? (For e <br />health, safety, 0 rkin&)t' <br />traffic conditions, etc.) <br />e4ji S' <br />le on pro erty al <br />d�Js,c) <br />