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A. <br />• 0 <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />Rezoning $100 <br />Special Use Permit $100 <br />Vacation of Right -of -Way $100 <br />Preliminary and Final Plat $100 <br />Division of Platted Lot $50 <br />Relocation of Dwelling $50 <br />Variance to Zoning Ordinance $50 <br />Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to the proper item numbers. <br />P�d'1 1 PA % 'e � c� <br />1' Middle (Last) (Phone) <br />Name of Owner: First) (Middle) <br />2. <br />Address of Owner: <br />3. ,�<L rn e, <br />Name of Applicant: <br />4. _ _ <br />Address of Appli <br />5. . 73 9 <br />Street Address o <br />T' l <br />o. and st-eet <br />rst <br />cant : (No. and 5tree <br />,e,j� s- <br />f Property Involved <br />4r6c-VI 81�-- <br />(city) <br />e <br />ast <br />(State <br />tate <br />PCjjj <br />5f-';ib1 j 1-/-c /V) k7 16.3' / 1 <br />6. Complete legal description of property involved: A sr A 7r-4 c h G= <br />S NE <br />i. Date Property Acquired: <br />8. Present Use of Property: %a 4� e h Proposed Use of Property: ,�cik' a e� <br />9. Present Zoning of Property: <br />10. What lan or change makes is req <br />Proposed Zoning of Property: <br />st necessary? e( C�l�_/ U'�- "'_. 1� �''ti'` o I'L2 <br />11. What is the expected effect of the proposed change? (For example, n <br />health safety, parking, traffic cond'tions, etc.) -- <br />,,, �, :. ��� k I c:- <br />propprty valu s, <br />