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CITY OF ROSEVI,LE <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />Rezoning <br />$100 <br />_ Division of Platted Lot <br />$50 <br />_ <br />Special Use Permit <br />$100 <br />_ Relocation of Dwelling <br />$50 <br />-�_ Vacation of Right -of -Way <br />$100 <br />Variance to Zoning Ordinance <br />$50 <br />Preliminary and Final Plat <br />$100 <br />_ <br />Z< Minor Variance <br />$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. i n Aon (+ <br />Name of <br />Owner: <br />(First) (Middle) <br />(Last) (Phone) <br />2. <br />�e-z�e.ro <br />eV,;,P <br />NNH ;si(3 <br />Address <br />of Owner: <br />_ <br />(No. and Street) (City) <br />(State) (Zip) <br />3. W�t�ior^ _ <br />Name of Applicant: <br />4. lk ) 16 L-Je5A"z r0 <br />Address of Applicant: <br />First) (Middle <br />No. and Street) (City <br />�.,D ` 7- f 3 3 9 a <br />(Last) (Phone) <br />(State) (Zip) <br />5.('-- <br />Street Address <br />of Property <br />Involved: <br />6. <br />Complete Legal <br />Des_cri.Lp-tiun�of <br />Involved:/ <br />`Property <br />7. <br />Date Property Acquired: <br />— <br />8. <br />Present Use of <br />Property: <br />Proposed Use of Property:+�r�e <br />9. <br />Present Zoning <br />of Property: <br />Proposed Zoning of Property: <br />10. <br />What plan or ch_an e makes this request necessary? 6uC - oju� 6e- <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />