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S <br />CIT'Y OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Mi-nesota 55113 <br />Please check item or items for which you are applying: <br />o Rezoning <br />_ Special Use <br />Permit <br />$100=�Divis,on of Platted Lot <br />$50 <br />__._ Vacation of <br />Right -of -Way <br />$100 — Relocation of Dwelling <br />$50 <br />_ Preliminary <br />and Final Plat <br />— Variance tZoning Ordinance <br />$100 Minor <br />$50 <br />— Variance <br />$25 <br />Please complete form by typing <br />are insufficient, use additional <br />item <br />or printing in ink. If the spaces <br />sheets, <br />numbers: <br />keying information to thep <br />roper <br />proper <br />Name o <br />2. <br />3. <br />4. <br />5. <br />J� , <br />Owner: <br />dress o <br />�I <br />(First) (Middle <br />Owner: (No. and Street) <br />Name of Applicant: (First) <br />(Middle; <br />�r0 /11tL D <br />Address of Applicant: S L <br />(No. and Street) <br />Street Adclrpec r,F n�__ <br />`PertY 1nvoiv ,d : <br />��'tii1� � r�•�IG���o <br />(Last) (Phone) <br />S�VrL�E 1- sil3 <br />(City) (State) <br />(Zip) <br />(Last) <br />'�sF VI�LC <br />(city) <br />6. Complete Legal Description of Property Involved: <br />L-eIS nine (9) ar,d' e`en (Iv) i n 15/oak two C <br />-(Phone) <br />AJ <br />State) (Zip) <br />7. Date Property Acquired: A�� <br />8. Present Use of Property: / <br />.�.`_._,._ . Proposed Use of Property: <br />9. Present Zoning of Property: <br />Proposed Zoning of Property; <br />10. What plan or change makes this request nec <br />'Piv' e ofs d essary? <br />rsc= 7�7r'c� • � L � , <br />11. What is the expected effect of the <br />Property values, health, safety,proposed change? (For exam le <br />i now Stele G parking, traffic conditions p on <br />etc.) <br />-L.�.-2�� _r.� ro i p (d <br />0 • <br />