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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 <br />$100 <br />Division of Platted Lot <br />$50 <br />Special Use Permit <br />$100 <br />_ <br />Relocation of Dwelling <br />$50 <br />— Vacation of Right -of -Way <br />$100 <br />_ <br />_ Variance to Zoning, Ordinance <br />$50 <br />— Preliminary and Final Plat <br />$100 <br />X Minor Variance <br />$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: 1. t EOAMR b ZF& <br />m u/l'son/ <br />Name of <br />Owner: (First) (Middle) <br />(Last) <br />(Phone) <br />2 . // 7 6 <br />W. <br />l� / L G rr� A a/ At)t' //2- V r <br />All <br />S�5 / / 3 <br />Address <br />of <br />Owner: (No. and Street) (City) <br />(State) <br />(Zip) <br />3. /- F0,ve4,12,b <br />�-e_4 V %V%I't IV SO A/ <br />. <br />ilci� ")t-'9S <br />Name of <br />Applicant: (First) (Middle) <br />(Last) <br />('hone) <br />4. // 7(, <br />W <br />/e t L /ri rq Al 4-v, y <br />All <br />Address <br />of <br />Applicant: (No. and Street) (City) <br />(State) <br />(Zip) <br />5. //76 <br />W, <br />�5I4rLL/)q '4A✓ /�uE <br />Street Address of Property Involved: <br />6. Complete <br />.Ld T .� <br />Legal Description of Property Involved: <br />4 qte b Ea/ /-/, I-e- S Iva - r <br />7. Date Property Acquired: J u1.Y I g S q <br />8. Present Use of Property: kesiacvcE Proposed Use of Property: 12Fs,,D c-Jva,6" <br />9. Present Zoning of Property: _ Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />C1/41 }6 E 3o Fee-7- svu-7-H 0P %ILC--5&N T GocAT.o Al <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />NoN F <br />