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i <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 />$100 <br />Division of Platted Lot <br />Relocation of Dwelling <br />$50 <br />$50' <br />Special Use Permit <br />Vacation of Right-of-way <br />$100 <br />_ <br />Variance to Zoning Ordinance <br />$50 <br />_ <br />Preliminary and Final Plat <br />$100 <br />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. <br />2. <br />3. <br />0 <br />Name of Owner: <br />1 SC <br />First) <br />Middle) <br />(n 5 I-16=o A/E4 02iye:- ttc <br />Address of Owner: (No. and Street) <br />Name of Applicant: (First) ( Middle, ) <br />4. 6-M 9E_lAle�, iykI L14�' f20-SC01 <br />Address;of Applicant: (No. and Stxpec� <br />_Z5 I-1C'1W4FZ, 012111E ST7 <br />5. & I - <br />Street Address of Property Inv lved: <br />&cdllk <br />(City) <br />YgY-756/_ <br />(Last) (Phone) <br />(State) (Zip) <br />YPL-7S-41 <br />(Last) -(Phone) <br />(State) (Zip) <br />qA) ,*S s /r 3 <br />6. Complete Legal D c0�t i on of Property nvo lved <br />O <br />SC <br />7. Date Property Acquired: JOk <br />g. Present Use of Property: Rom_. Proposed Use of Property: RES <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan nor „hinge makes this heq � t n .,.,A varry?A ^ � r <br />11. What istheexpected effect of the proposed change? (For example, on <br />prope tx values, heal h, safety, p ki traff'c cond'ti ns etc.) <br />