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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <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 />�` Minor Variance <br />$25 <br />Please complete form by typing or <br />printing in <br />ink. If the spaces provided are <br />insuffici <br />use additional sheets, keying information to <br />the proper item numbers. <br />14- "r • g424� <br />'� we 332- <br />153� <br />ame of Uwner: (rirst) (Middle) (Last) <br />2. 2.tG"If 1�0. I <br />Address of Owner: (No. and <br />3. (��r-, / <br />Name of Applicant: (First) <br />treet <br />(i,u.aaie <br />(City) <br />t <br />NAQ l t� <br />tate) (Zip) <br />one) <br />4. <br />Address of Applicant: (No, and Street) (City) (State) (Zip) <br />5 . 1-64 160. F05eyX'00 i.PcrJ Fit l� <br />Street Address -of Property Involved <br />6. Complete legal description of property involved: <br />tiles A GT nel <br />7. Date Property Acquired: <br />8. Present Use of Property: f3bhe Ffty FO�A%PMproposed Use of Property: �NAe <br />9. Present Zoning of Property: �l: l ��. Proposed Zoning of Property: �J�V1k51 <br />10. What plan or change makes this request necessary? <br />M M! <br />11. What is the expected effect of the proposed change? (For example, on property values; <br />health, safety, parking, traffic conditions, etc.) <br />