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A <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 />Special Use Permit $100 <br />Vacation of Right $100 <br />-of-Wa <br />__._ Preliminary and Final Plat $100 <br />$100 <br />Division of Platted Lot $50 <br />Relocation of Dwelling $50 <br />_ Variance to Zoning Ordinance $50 <br />yam/ Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces <br />Pr <br />are insufficient, use additional sheets, keying information to theproper <br />item numbers: per <br />1. <br />NAm'n '-F <br />2. <br />3. <br />4. <br />5. <br />''WlL <br />Gwcier: (First) (Middle) <br />r 42,-7 <br />Address of Owner: <br />�i SNl�l1.1 �v�lit (zoSC::-V/j (5- <br />(No, aand Street) (City) <br />vJ I L� 1 <br />N��Ir,J� 1-f ame of Applicant: <br />(First) (Middle) <br />/44,2-7 -T'..q4lS�-r.4�1 �2Ve- <br />Addr c.JJ c,z` Hpp 1-icant . ( No . and S tt ) <br />(City) <br />�33 - 9#Sr7 <br />i Z .!;-q ±-9/Z/ <br />(Last) (Phone) <br />mhj <br />(State) (Zip <br />(Last) _(Phone) <br />(State) ( ZI_PP ) <br />Street Address of Property `J �: <br />Involver <br />6. Complete Legal Description of Property Involved: <br />7. Date Property Acquired:��� <br />8. Present Use of Property: <br />A Proposed Use of Property: No <br />9. Present Zoning of Property: <br />�Sr�tucL' . <br />roposed Zoning of Property: <br />0. What plan or change makes this request necessary? <br />pc� <br />---�.� ' L L!l <br />11. What is the expected effect of the <br />property values, health, safet proposed change? (For example, on <br />Y parking; traffic conditions, etc.) <br />iT �,`!../d LIB Ctill�.A-n/^.{ <br />A L/ <br />