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CITY OF ROSEVILLE <br />2660 Civic Center Drive <br />Roseville, Minnesota <br />Please check item or items for <br />which you are <br />applying: <br />Rezoning <br />Special Use Permit <br />$100 <br />$100 <br />Division of Platted Lot <br />$50 <br />_ <br />Vacation of Right -of -Way <br />$100 <br />Relocation of Dwelling <br />—"" Variance to Zoning Ordinance <br />$50 <br />$50 <br />Preliminary and Final Plat $100 <br />Minor 1,ariance <br />$25 <br />Please complete form by typing <br />use ade" tional sheets, keying information <br />or printing in <br />to <br />ink. If tYe spaces provided are <br />the <br />insufficient, <br />Q t � y ► NA) <br />proper to numbers. <br />M rt urLL n-A) <br />u r`'�'�Y`''�� <br />Name o Owner first <br />(Mid le <br />( Last <br />(Phone) <br />2 • a"R q , p �J <br />I <br />Qoseu, I AA A, A.1 <br />SS - <br />Address of Owner: (No. and <br />Street <br />(City) (State) <br />(Zip) <br />3. L-- <br />iM <br />\A C•Gl.�►2. <br />Name of ADDliC t . (M rsf) <br />rAlf" aai _1 ,. <br />_ <br />4. <br />20H of <br />AQ <br />' Lt.E WA %A) A) <br />ress o Applicant: No. an Street)City <br />State (Zip) <br />S. <br />Z.� IL sr. <br />Street Address of Property Involved <br />6. <br />Complete legal descripti�onn of property involved: <br />I<ro 1 S uj e ,-�'Weo <br />L 0 4 <br />Q c-OG c <br />7. <br />Date Property Acquired: <br />8. <br />Present Use of Property: 2esabejuete- <br />Proposed Use of Property: i2'$ip?xza <br />9. <br />Present Zoning of Property: S kQ�f, rktMi�1� lroposed <br />Zoning of Property: Fitrat�,� <br />-�.. <br />10. <br />What plan or change makes this request necessary? <br />,544*u t c be wee A <br />jEre5esil Gone 1�e d ;r�s /O o f <br />P ICO R'ej ini <br />r o 05e O V-4gqws1bv 0- e <br />e i eS <br />o N ---�— <br />Se . <br />r X. a <br />►i �a�,e re kc �c N <br />; ex e}rvra e <br />11. <br />What is the expected effect of the proposed change? (For example, on <br />health safet P property values, <br />y, parking, traffic conditions, etc.) <br />e- a dJUA-lue, -g« <br />ill l: d �-cf v L e F G <br />N <br />