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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <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 Lot $50 <br />— Relocation of Dwelling $50 <br />_ Variance to Zoning Ordinance $50 <br />_ Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided <br />are insufficient, use additional sheets, keying information to the proper <br />item numbers: <br />1. <br />Name of Owner: <br />2. ) I Cn 7 W�'s-F <br />Address of Owner: <br />3. '5 a,Name of Applicant: <br />4. <br />J-A� 0 <br />(First) <br />-t'� 1�� <br />No. an <br />First) <br />(Middle) <br />R-s-L 4, U.R_ <br />Street) <br />(Middle) <br />f�-oU, "'j V-89-r)38 <br />(Last) (Phone) <br />(City <br />MN' <br />ss„ 3 <br />(State) (Zip) <br />(Last) (Phone) <br />e6s or Applicant: (No. and Street) (City) (State) (Zip) <br />5. -S a„�,c•, sL <br />Street Address of Property Involved: <br />6. Complete Legal Description of i;operty Involved: <br />z. I jg1-ot.lc I S c- 6.�bR,� o - -- <br />7. Date Property Acquired: 1qS j <br />8. Present Use of Property: Proposed Use of Property: <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />