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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 />— Relocation of Dwelling <br />$50 <br />— Vacation of Right -of -Way <br />$100 <br />Variance <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: <br />1. i A -5 s <br />E ► T- 2-M ' A <br />Name of VLer: <br />+� A B Q-T <br />(First) <br />J+ <br />(Midd e) <br />(Last) <br />(Phone) <br />2. `t'� SS Su. <br />api Asso <br />tLv b . <br />©SEV I LLB <br />Address of Owner: <br />(No. and Street) <br />(City) (State) <br />(Zip) <br />3. <br />Name of Applicant: <br />47 tj a 'r+l <br />(First) <br />E �v a R R <br />(Mi le) <br />1-a-� <br />rJ (Last) <br />(Phone) <br />4 . _ '� S S' o , <br />-� SSo <br />t_ V !) <br />S' )13 <br />Address of Applicant: <br />(No. and <br />Street) <br />(City) (State) <br />(Zip) <br />5. 'qSS- SO. <br />OwA SSo <br />i LV3- <br />. <br />Street Address of Property <br />Involved: <br />6. <br />Complete pLegal Description of <br />G <br />Property Involved: TH r POET %F �njr& dap <br />►ri s R v tj <br />L upg a�J <br />t I Ajr201-12 � p <br />(OT-JIUD A L11/ Ida t" cT` <br />�lSTi4NT rl�a�9:-�sLom� <br />P�A� Attic. EPE fa1►Ti1 <br />o ces c� , u ?N� o�Fic� n� Tt � Cctiw u-r>r ea<e-aeaG <br />CoH NTy • c RAmsQy) Q <br />W jrjj iJl AND PORL <br />7. <br />Date Property Acquired: 7— <br />JIAJ�ib <br />6. <br />S 114 G, L E 'Ffl ►n,,y <br />Present <br />mal'y <br />Use of Property: m <br />Proposed Use of <br />Property: <br />9. <br />Present Zoning of Property: <br />Proposed Zoning <br />of Property: <br />10. <br />What plan or change makes this <br />request necessary? <br />dC,cs,7 4, a �.Q 2 (Z ` <br />1C (`f S� r-e �. A o rtit~ <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />L <br />v <br />4 <br />c/o rt -7-e � w lea . %�.� ; (4 a v-ev� P rt v zvq lv`- <br />