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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 />— Special Use Permit <br />$100 _ <br />$100 <br />Division of Platted Lot <br />Vacation of Right -of -Way <br />_ <br />$100 <br />Relocation of Dwelling$50 <br />Variance <br />— Preliminary and Final Plat <br />_ <br />$100 <br />-X <br />to Zoning Ordinance <br />Minor Variance <br />$50 <br />$25 <br />Please complete form by typing <br />are insufficient, use additional <br />or printing in ink. If the spaces <br />sheets, keying <br />item numbers: <br />information to the <br />provroper roper <br />Name of Owner: (First) (Middle) <br />2. 976 <br />Address of Owner: (No. and Street) <br />3. 10ljN THF-41 <br />4. <br />5. <br />Name of Applicant: (First) (Middle.) <br />_ 9 7G <br />Address of Applicant: (No. and Street) <br />2974 V,c�� <br />street Address of Property Involved: <br />4 <br />(Last <br />r <br />(City) <br />Avo C r4 <br />(Last) <br />y/1. c r <br />City) <br />6. Complete Legal Description of Property Involved: <br />.�, -� . � '% - - - - - <br />3 .-- <br />(Phone) <br />9A/ s Z <br />State) (Zlp) <br />(State) <br />7. Date Property Acquired: -o2 7 - 8 ( <br />8. Present Use of Property: ���, Proposed Use of Property: _ <br />9. Present Zoning of Property: k0-5.. Proposed Zoning of Property. • ��`�� <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the <br />property values, health, safety, proposed change? (For example, on <br />C11-parking, traffic conditions, etc.) <br />