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V <br />1 <br />CITY OF ROSEVILLE <br />w 2660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />YRezoning $100 Division of Platted Lot $50 <br />_ Special Use <br />Permit <br />$T00 <br />Relocation of Dwelling <br />$50 <br />— Vacation of <br />Right -of -Way <br />$100 <br />_ <br />Variance to Zoning Ordinance <br />$50 <br />_ Preliminary <br />and Final Plat <br />$100 <br />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: <br />1. 2�75711�671�C <br />Name of Owner: <br />2. ojy <br />Address of Owner: <br />3. 1E.:5rh �,k <br />4. <br />5. <br />6. <br />(Fist) (Middle) <br />(No. and Street/)_ (City <br />Avly <br />Name of Applicant: (First) (Middle) <br />Address of Applicant: (No. and Street) <br />�2o 5��4 <br />Street Address of Property Involved: <br />Complete L gal Description <br />�T '::; r- : `> 0 <br />LC':AC& <br />(City) <br />Property Involved• <br />'� of4 ?'9 <br />(Last) (Phone) <br />(State) (Zip) <br />(Last) <br />(Phone) <br />(State) (Zip) <br />4/A/ <br />200-0X a <br />7. Date Property Acquired: <br />f- <br />8. Present Use of Property: S PL-� Proposed Use of Property: �p <br />9. Present Zoning of Property: PEE Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? 7-2' <br />11. What is the expected effect of the proposed change? (For example, on <br />prop rty values, Pealth, safety, parking, traffic conditions, etc.) <br />