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—Tc3re- A-o v3CL NZO\-1 <br />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 />$50 <br />_ <br />_ Special Use Permit <br />$100 <br />Relocation of Dwelling <br />to Zoning Ordinance <br />Vacation of Right -of -Way <br />$100 <br />_ Variance <br />$20 <br />Preliminary and Final Plat <br />$100 <br />7!C Minor Variance <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. <br />Name 0-4 Owner: <br />2 . i .Py j <br />}p t _� q <br />2 <br />Address ofOwner: <br />3. <br />First,. )) (Middle) <br />(No. and Street) <br />Name of Applicant: (First) <br />4. t` -fie C2::, 04k ` <br />Address of Applicant: (No. and <br />5. <br />(Middle) <br />(Last) <br />City)City)�tate)) <br />Cc: t'q- � 4 <br />(-Last) <br />reet) (City) <br />Street Address of Property Invoivect: <br />6. Complete Lega <br />nnPrty Tnvolved: <br />33-1 <br />S <br />(Phone) <br />`(Zip) <br />93 -t9S <br />(Phone) <br />(State) <br />(Zip) <br />7. <br />Date Property <br />Acquired: <br />8. <br />Present Use of <br />Property: <br />`p,� ,. Proposed Use of Property: Q <br />9. Present Zoning of Property: . Proposed Zoning of Property: n6C" <br />10. What plan or change makes this request necessary? ( ` <br />f A =ce diV " v \ \nn Mw '( : n e YCt�` C3tlrr►� g f% YLh -V-KIS U?� n "9 o ci_ to mei) <br />AMU <br />CjDk\55 <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safe <br />\ty.,, parking, traffic tconditions, etc.)( <br />a _ A. a,i-,.\V _ \!i"� U \ n .Y /`aV v��i-1a .. i tiff �i�.� il'1 /1 (`� Irs f�'C. _ I in <br />I <br />