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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 <br />_ Special Use Permit — $50 <br />5100 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 <br />$25 <br />Please complete form by typing or printing in ink. If the spaces ed <br />are insufficient, uie additional sheets, keying information to thep roper <br />item numbers: proper <br />1. I r�1;'� I`js L°/V <br />Name of Owner A � L <br />(First) (Middle) (Last) (Phone) <br />3416 __Auc qcl� �77 <br />3L V, <br />Address of Owner: (No. and Street) (City) (State) <br />(Zip) <br />3. %^l�l C7 {'Y) , 4 41 C.E�t.l - /V 1 ut� C C__ /C -76 3 -� v� (� <br />Name of Applicant: (First) (Middle) <br />(Last) (Phone) <br />3 �b of ��G� ST ;(o �� <br />Address of Applicant: UI//� "�� 55 13 <br />(No. and Street) (City) (State) (Zip) <br />6-5-113 <br />Street Address of Prcrer_ty involved: <br />Co plete Legal Descriptloa of Proper y Involved: 4 0T �o Bzock. <br />!J U fYl a A) <br />Date Property Acquired: (� p <br />Present Use of Property: Proposed Use of Property: <br />Present Zoning of Property: &S' a 1/ Ptroposed Zoning of Property: <br />What plan or change makes this request necessary? /ti.14.0le - A-1.) 1<1t�' �LJ'2 <br />4. <br />5. <br />6. <br />7. <br />8. <br />9. <br />10. <br />11. What is the expected effect of the proposed change? <br />property values, health, safety, parkin c (For example, on <br />10� /�� � ��������� AEC.9LLe_ J� g, traffic conditions, etc.) <br />/ . , a ,o a / mot, t � G� c) ,.�i.0 <br />FAN <br />