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6 0 <br />i <br />owei55 . <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />$100r <br />Division of Platted Lot <br />$SO <br />$SO <br />Rezoning <br />$100 <br />Relocation of Dwelling <br />Special Use Permit <br />$100 <br />� Variance to Zoning Ordinance <br />Vacation of Right -of -Way <br />$100 <br />Minor Variance <br />$25 <br />Preliminary and Final Plat <br />complete form by typing or <br />Please com P <br />printing in <br />ink. If the spaces provided are <br />item numbers. <br />insuffic,iei <br />use additional sheets, keying information to <br />the proper <br />.— <br />Name of Owner T. <br />Address of 0«r <br />3. <br />Name of <br />a. 1164 <br />Address <br />WAY <br />first <br />r0(Wil <br />er: (No. and Street <br />0 <br />licant: (First) <br />Aaplicant: (No. and Street <br />S. <br />Street Address - of Property Involve <br />6. Complete legal description or <br />4-h P 1 _ Chi <br />Idle) <br />Psevflle <br />(City <br />(�fiddle) <br />fifewi,(w <br />CLe'fi I <br />7. Date Property Acquired: .S�°���, 10, 16-IM <br />8. Present Use of Property: <br />9. Present Zoning of Property:P��lc�=�.f <br />qllcy —0727- <br />ist) w Phi <br />61,00 f sq.-IN <br />(state) <br />{Last) <br />KIVI'l ZSOiGv <br />ty) (State <br />L d+ <br />9,57(1 3 <br />(Zip) <br />(Phone) <br />�4fe 3 — <br />(zip <br />0 _�4 . CA, +V) <br />Proposed Use of Property: <br />Proposed Zoning of Property: Sc�ry�F. <br />10. What plan <br />or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on property values, <br />health, safety, parking, traffic conditions, etc.) <br />