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i • �' <br />e <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 $100 _ Division of Platted Lot $50 <br />_ Special Use Permit $100 _ Relocation of Dwelling $50 <br />_ Vacation of Right -of -Way $100 _ Variance to Zoning Ordinance $50 <br />_ Preliminary and Final Plat $100 Minor Variance $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: p <br />1. /q 01_ ) L!J! ,/- ,G- rA !-I 13 D #Al <br />2. <br />3. <br />4. <br />5. <br />6. <br />Name of Owner: (First) (Middle) <br />ess of Owner: "(No. and Street) (City) <br />Name of Applicant: (First) (Middle) <br />/ z — 1—,e `l?lV "la er -PYO SI <br />Address of Applicant: (No. and Street) (City) <br />! .O ,-;L _/; /= 4=/RA/ /W l_7 2 <br />Street Address of Property Involved: <br />Complete Legal Description of Property Involved: <br />(Last) (Phone) <br />(State) (Zip) <br />oedgw 46 A16 /! <br />(Last) (Phone) <br />eLLr MIAIA/,- 675— // <br />(State) (Zip) <br />7. Date Property Acquired: 7 - S- 4 <br />8. Present Use of Property: Proposed Use of Property: <br />9. Present Zoning of Property: Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on <br />property values, health, safety, parking, traffic conditions, etc.) <br />