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I <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 X 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 />1. Name of Owner: (First) (Middle) (Last) (Phone) <br />2. <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />3. . ,JU's L=-Fq 7 Pc- cK �/'?l-ilfo <br />Name of Applicant: (First) (Middle) (Last) (Phone) <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />7 5. <br />Street Address of Property Involved: <br />6. Complete Legal Description of, Property Involved: _500 Tf 7J�r-e -,-T Of= <br />rftE ��'T/� wc� f�v�IDREp /lFT �% ivF Af_�7- f %,9�1— ��Qr <br />/l �V<0n1 �lt� �o is �v iN� `�sTc�eL t! O� 7ifr s�.sT� iN,�- Fir A Sr�a�� GF-- <br />�tND Z 6 F T �✓r��' COiYt�/ X I--D/*-� I=H,GiTV OF —S r f A114 <br />,L FC <br />7. Date Property Acquired: <br />8. Present Use of Property: Proposed Use of Property: Ik S <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />t7r--P714 DF �U'T <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />