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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 to Zoning Ordinance <br />$50 <br />_ Preliminary and Final Plat <br />$100 <br />_ .linor Variance <br />$25> <br />Please complete form <br />by typing or <br />printing in <br />ink. If the spaces provided <br />are insufficient, use <br />additional <br />sheets, keying information to the proper <br />item numbers: <br />Name of Owner: <br />(First) <br />(Middle) <br />(Last) (Phone) <br />2 . <br />L/6 f Ie?,1941aiadr> <br />/ras ps ' AM ' 3 <br />Address of Owner: <br />(No. and <br />Street) <br />(City) (State) (Zip) <br />3. <br />4. <br />5. <br />Name of Applicant: (First) (Middle) (Last) -(Phone)' <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />y <br />street Aaaress of Property Involved: <br />6. Complete Legal Descript'on of Property Involved: <br />tit <br />7. Date Property Acquired: /x* <br />8. Present Use of Property:AaAv�aProposed Use of Property: <br />9. Present Zoning of Property AGA6 Proposed Zoning of Propertyx/-47�� <br />10. What plan or change makes this request necessary?��� <br />0 ,�,b,,,�,4 <br />An . • -lrw si..w AV — . - _ r — -- <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking. traffi rnnntii f-i nnc otn I <br />