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0 <br />la,71P4 <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 Owner: (First) (Middle) (Last) (Phone) <br />2. <br />Address of Owner. (No. and Street) (City) (State) (Zip) <br />3. ..S�AjL A:c <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br />4: <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5. <br />Street Address of Property Involved: <br />6. Complete Legal Description of Property Involved: <br />7. Date Property Acquired: r A 19 <br />8. Present Use of Property 14 <br />P - Y � � � Proposed Use of Property • 044 <br />9. Present Zoning of Property: `� Proposed Zoning of Property: 'y <br />10. What plan or change makes this request necessary? /J,�1%�c.�✓,A <br />�y�A-JA . 11 <br />Gli`/ /Q+ !%/� L-i°"eT• -4l 'e -./ <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />