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1. <br />CITY OF ROSEVILLE <br />?660 Civic Center Drive <br />Roseville, Minnesota 55113 <br />Please check item or items for which you are applying: <br />— Rezoning $100 <br />Special Use Permit $100 <br />Vacation of Right -of -Way $100 <br />Preliminary and Final Plat $100 <br />Division of Platted Lot $50 <br />_ Relocation of Dwelling $50 <br />_ Variance to Zoning Ordinance $50 <br />v'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. �t-nc ICY �..<- o �A. �► �C, C� �r �� 7 �r Y <br />Name of Owner: <br />Address of Owner: <br />(First) <br />(Middle) <br />(No. and Street) <br />3. �-tv rj (--t- i �-co <br />Name of Applicant: <br />4. <br />5. <br />6. <br />(First) (Middle) <br />Address of Applicant: <br />e <br />Last) (Phone <br />(City) (State) (Zip) <br />(aL--761Y <br />IP <br />(No. and Street) (City) <br />Street Address of Property Involved: <br />Complete Legal Description of Property Involved: <br />(Last) (Phone) <br />(State) (Zip) <br />•L I <br />7. Date Property Acquired: ��� , 4-1 <br />8. Present Use of Property: i1oM C- Proposed Use of Property: U ars-e <br />9. Present Zoning of Property:_ Proposed Zoning of Property:�GS. <br />10. What plan or change makes this Jrequest necessary? Opc- e-? <br />-hb% , c ra 3� 4o c. o. f c S .G � 712 �2 4 fi %— N �. <br />11. What is the expected effect of the proposed change? (For example, on <br />prop,r�y values, health, safety, parking, traffic conditions, etc.) <br />