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r <br />CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />• <br />Roseville, Minnesota <br />Please check item or items for which you are applying: <br />Rezoning $106 Division of Platted Lot <br />Special Use Permit $100 Relocation of Dwelling $50 <br />50 <br />Vacation of Right -of -Way $100 Variance to Zoning Ordinance Preliminary and Final Plat $100 g $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 />J <br />Name of Owner. (First) Middle �G�' '2 <br />( ) (Last) (Phone) <br />2. Jr-J�- �D uC'�G �1iC <br />Address of Owner: (No. aCit j nd Street) 1 L �` MA) �- <br />( Y) "'-'- <br />3. �' Z-49 � ti _ (State) (Zip) Name of Applicant: (First) <br />Middle) �A L/1f2-/zr� SS d' <br />( <br />(Phone) <br />4. <br />Address of Applicant: (No. an Street <br />(City (State) (Zile) <br />5 • S �-n� � - <br />Street AMess of Property Involved <br />6. Complete legal description of property involved: <br />7. Date Property Acquired: <br />8. Present Use of Property: <br />9. Present Zoning of Property: <br />Proposed Use of Property: <br />Proposed Zoning of Property: <br />10. What plan or change makes this request necessary? <br />11. What is the expected effect of the proposed change? (For example, on property values <br />health, safety, parking, traffic conditions, etc.) <br />----------------- <br />