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1] <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 <br />$100 <br />Division of Platted Lot <br />$50 <br />Special Use Permit <br />$100 <br />Relocation of Dwelling <br />$50 <br />$50 <br />Vacation of Right -of -Way <br />$100 <br />Variance to Zoning Ordinance <br />$25 <br />Preliminary and Final Plat <br />$100 <br />Minor Variance <br />Please complete form by typing or <br />printj-ng in <br />ink. If the spaces provided are <br />insufficient, <br />use additional sheets, keying information to <br />the proper item numbers. <br />1. <br />2. i-f' (jam',v % <br />Address of Owner: (No. and Street) (City) (State) (Zip) <br />Name of Applicant : (First) (Middle) (Last) (Phone) <br />4. <br />Address of Applicant: (No. and Street) (City (State <br />Street Address of Property Involved <br />6. Complete, legal description of property involved: ­T�Itf". qq <br />It <br />7 <br />7. Date Property Acquired: <br />_�. <br />8. Present Use of Property: ke-��I�I� n-�iGl l Proposed Use of Property: I <br />9. Present Zoning of Property: kt) dL1_1 Proposed Zoning of Property: <br />lo. What plan or change makes this ^request necessary? ,liC� �:� /`.�TO,�"�h� <br />11. What is <br />the expected effect of the proposed <br />change? <br />(For example, on property values, <br />health, <br />safety, parking, traffic conditions, <br />etc. <br />........ <br />ro - 4� 41/ " <br />