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J <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 />_ Rezoning $100 _ Division of Platted Lot $50 <br />_ Special Use Permit $100 _ Relocation of Dwelling $50 <br />_ Vacation of Right -of -Way $100 Variance to Zoning Ordinance $50 <br />Preliminary and Final Plat $100 --,'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 />Name of w0 ner: (First) (Middle) (Last) (Phone) <br />2 . 5/- % 9' // A ✓te Rd s cy dlee . Mi; <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />3. /Vi �tiQ la S �z BSc ijyi :C�W &`j'! <br />�83 -21 <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br />4 . el % 9 4 o ✓z // f1ye, S-e V / llc-. h h . <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. -3a m t <br />Street Address of Property Involved: <br />Al <br />7. <br />8. <br />9. <br />10. <br />11. <br />Complete Legal Description of Property Involved: <br />Date Property Acquired: <br />Sih-p/4 Pyoposed Use of Property: ,Sayer <br />Present Use of Property: ho mA&e. <br />Present Zoning of Property:{?csid"`/;P'roposed Zoning of Property: Sgh• e� <br />What plan or change makes this request necessary? �Gidd1,4-j'dn <br />What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking�,traffic conditions, etc.) <br />