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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 <br />applying: <br />Rezoning $100 <br />Special Use Permit $100 <br />______._ Division of Platted Lot <br />Vacation of Right -of -Way $100 <br />Relocation of Dwelling <br />Variance <br />$50 <br />Preliminary and Final Plat $100 <br />to ZoningOrdinance <br />Minor Variance <br />$25 <br />$25 <br />Please complete form by typing or printing in <br />use additional sheets, keying information <br />ink. If the spaces provided are insufficient <br />to <br />the proper item numbers. <br />' <br />1• b r P r G vr' e snu <br />Nair:; oOwner: First (Middle) <br />Last <br />(Phone) <br />2. <br />A ress Of Owner: No, an Street <br />CityState) <br />Zip) <br />3' S e <br />Name o Applicant: First (Middle Last <br />(Phone) <br />4' Same <br />A ress o pplicant: No. an treet <br />(City) State <br />Zip <br />5. <br />Street Address o Property Involved <br />6. <br />Complete legal description of <br />Town Block -1 <br />property involved: Carols Gard en Section Lot 22 <br />7. <br />Date Property Acquired: November 1953 <br />8. <br />Present Use of Property: Si-up1_e <br />family 1:11ridenoe Proposed Use of <br />Property: <br />9. <br />Present Zoning of Property: <br />0 <br />Proposed Zoning of <br />Property; <br />10. <br />What plan or change makes this <br />request necessary? Plan to build a <br />10 1 addition <br />e use <br />11. <br />What is the expected effect of the proposed change? (For example, <br />health, safety, parking, traffic conditions, <br />on property values <br />thp ��v <br />etc.) <br />.. oetev value <br />............. <br />... . <br />19�t.1h d o { d �G�.oG�O� he/�i�Orl <br />