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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 $100 <br />Minor Variance <br />$25 <br />Please complete form by typing <br />or printing <br />in ink. If the spaces provided are <br />insufficient, <br />use additional sheets, keying <br />information <br />to the proper item numbers. <br />1. <br />l : ci.y ncy 09s'o, 6 <br />31' <br />Name of Owner: (First) <br />(Middle) (Last) <br />(Phone) <br />2 . t� y � )e 'C_o St :;a- <br />f> l <br />L 4(2 cj�'n'jm f -1 IV • <br />T-S-) L ? <br />Address of Owner: (No. and <br />Street) <br />(City) (State) <br />(Zip) <br />3. <br />(JA M <br />taS A3c V E ) <br />Name of Applicant: (First) <br />(Middle) (Last) <br />(Phone) <br />4. <br />Address of Applicant: (No. and Street) (City) (State) (Zip) <br />5 . 090 w. C.6 . RCP . <br />Street Address -of Property Involved <br />6. Co►aplete legal description of property involved: Lol , 'j(a(-J< I , Parr'aP+4D <br />P,`,sj /QcP `� do dose✓� IIc car, tcy C� <br />t <br />7. Date Property Acquired: <br />8. Present Use of Property: S--T ""� jdP -I� L& Proposed Use of Property: S`-/Q <br />9. Present Zoning of Property: Proposed Zoning of Property: R —� <br />10. What plan or change makes this request necessary? k,5— coiner- 1c4 alas a m,,%, do tbuak�d N <br />` <br />reams?rah w{>; ck '.s Qe kc, ll v ah V�Q-J Si'Cl2 &P'1 O%Ar �� aS we yo0d i fe- tke- hotnq- pitc!d . ,g)c <br />ire! P, re Miw..�_ IJnr:aheG `,n ,fot,J I , 0n .r SlITQ 'ncf `6td <br />11. What is the expected effect of the proposed change? (For example, on property values, <br />health, safety, parking, traffic conditions, etc.) 411 o¢hcr hamtzt ;, -Ke amA a.re <br />Ce . IQ- C- .�- <br />