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• <br />0 <br />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 />$100 <br />Division of Platted Lot <br />$50 <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 V <br />Minor Variance <br />$25 <br />Please complete form by typing <br />or printing in ink. If the spaces <br />provided <br />a:�e insufficient, use additional sheets, <br />keying information to the <br />proper <br />item numbers: <br />1. <br />Name of Owner: <br />2. Zo .1 O /Jo <br />Address of Owner: <br />4. <br />z' C <br />(First) (Middle) <br />(No. and Street) <br />(Last) <br />7 W 0'31�e3 <br />Phone) <br />/%& S:5_ / / <br />(City) (State) (Zip) <br />Name of Applicant: (First) (middle) (Last) (Phone) <br />Address of Applicant: <br />(No. and Street) (City) (State) (Zip) <br />5. <br />Street Address of Property Involved: <br />6. Complete Legal Description of Property Involved: p►y <br />7. Date Property Acquired: <br />5) NC�c.L <br />8. Present Use of Property: VA.cM-Proposed Use of Property: r-14Wkit h}GM1F <br />9. Present Zoning of Property: P_-1 Proposed Zoning of Property: 121 -1 <br />10. What plan or change makes this request necessary? )C- 6j0Lk L <br />L I I_ L 70 5 I�'Li 1 j -I-j (y TW o L <br />C7 I �� <br />Mak-C• A- -TH IQn Ln`r . <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />