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re 2'° 51 <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 />PUD <br />$750 <br />Ccunprehensive Plan Ameni rent <br />$750 <br />Rezoning <br />$300 <br />Division of Platted Lot <br />$100 <br />Special Use Permit <br />$200 <br />_ Relocation of Dwelling <br />$100 <br />Vacation of Right -of -Way <br />$200 <br />Variance to Zoning Ordinance <br />$200 <br />Preliminary and Final Plat <br />$500 <br />Shoreline Permit <br />$ 50 <br />Please crn>plete form by typing or printing in ink. If the spaces provided are <br />insufficient, use additional sheets, keying information to the proper item numbers: <br />Name of owner: (First) <br />(Middle) <br />(Last) (Phone) <br />2. <br />i r e �r?se iril/e <br />/UI/1� <br />sli 3 <br />Address of Owner: (No. and Street) <br />(City) <br />(State) Zi p) <br />3. <br />rl / Y t /4 -e ..fin (. <br />Ct /h PJ ,�. <br />/�( <br />�GfJ Unit //bii/-1i/7 0 7G`iP 2 <br />(Name of Appl-icant): (First) <br />(Middle) <br />(Last) (Phone) <br />4. <br />(Address of Appl.): (No. and Street) <br />(City) <br />(State) (Zip) <br />5. <br />-5 nI e <br />Street Address of Property Involved: <br />6. <br />Complete Legal Description of Property Involved: <br />V- - -L Z 3 OO ZQ <br />Sec (12) Twn (29) Range (23) <br />S i i h Tn 9 T H 49L1'?h Tha R I I A 91.11nn <br />FC Of <br />N. 369 75/100 Ft <br />Of E 253 Ft Of NE 1/4 Of Sec 12 <br />TN 29 Rn <br />23 <br />7. <br />Date - Property Acquired: / 9 7� <br />8. <br />Present Use of Property: g"fe"I <br />9. Present <br />Zoning of Property: <br />Propooe3 Use of Property: SLr Ht e <br />Prepccsed Zoning, of P.-cper`,r: <br />10. <br />11. <br />Present Comprehensive Plan Designation: <br />Proposed Comprehensive Plan Designation: <br />-What plan or change makes this request necessary? C'14 <1�e I;i <br />12. What is the expected effect of the proposed c-oMe? (For example, on property <br />values, health, safe par}cirtg, traffic conditions, etc.) <br />nn nip./ �r�lPn f Gtk, a ,� <br />