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rM <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 <br />$100 _X <br />Division of Platted Lot <br />$50 <br />_ <br />Special Use Permit <br />$100 <br />Relocation of Dwelling <br />$50 <br />_ <br />Vacation of Right -of -Way <br />$100 <br />Variance to Zoning Ordinance <br />$50 <br />_ <br />Preliminary and Final Plat <br />_ <br />$100 _ <br />Minor Variance <br />$25 <br />Please complete form by typing <br />or printing in ink. If the spaces <br />provided <br />are insufficient, use additional sheets, <br />keying information to the <br />proper <br />item numbers: <br />1. <br />Name of Owner: <br />2. <br />Address of Owner: <br />3. <br />Name of Applicant: <br />4.- <br />Address of Applicant: (No. and Street) (City) `(Sta/t�e) (Zip) <br />y <br />Street Address of Property Involved: <br />First) <br />L <br />(Middle) <br />//V;E-4 <br />(Last <br />P335"/111e`i�1h'i s �ts�,�7/y �s ems = i.�iLl, Alle <br />(No. and Street) (City) - (State) <br />First) (Middle) (Last) <br />98- 7/f77 <br />(Phone) <br />.."%/ sr <br />(Zip) <br />„( Phone ) <br />6. Complete Legal Description of Property Involved: <br />7. Date Property Acquired: �t 'tSwf / <br />8. Present Use of Property: /1�� Proposed Use of Property: AgtEu/AA-- � <br />9. Present Zoning of Property: R-J' Proposed Zoning of Property:Z <br />10. What plan or change makes this request necessary? -�7A''Y $ <br />4 <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />