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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 $100 <br />Special Use Permit Division of Platted Lot $J0 <br />Vacation of Right -of -Way $100 _ Relocation of Dwelling $50 <br />Preliminary and Final Plat Variance to Zoning Ordinance $50 <br />$100 Minor Variance $25 <br />Please complete form by typing or printing in ink. If the spaces <br />use additional sheets, keying information to the proper itemnumbersovided are insufficient, <br />1. <br />Name of Owner. (First) (M� Ae) t �D �� �' <br />2. ��0 (Last) (Phone) <br />Iq P.�,2 Doe �d„SEtJ�1L� Address of Owner (No. and Street) (City) ---� <br />( Y) (State) <br />3• /U 7`110A) <br />Name of Applicant: first) (Middle) (Last) ( ) (Phone) <br />4. /F<P6 DRyqopZ�e po <br />Address of Applicant: (No. anU Street `S to <br />(City)) (State) (Zip) <br />5 • � ��'"0 17 � <br />Street Address of Property Involved <br />6. Complete legal description of property involved: <br />7. Date Property Acquired: <br />8> Present Use of Property: � s✓ � �%D _ Proposed Use of Property: <br />9. Present Zoning of Property; Fs��� � -" <br />/f7L Proposed Zoning of Property; fs<�•�T� ,, <br />10. What plan or change makes this request necessary? r <br />1,00 <br />11. What is the expected effect of the proposed change? (For example, on ro ert <br />health, safety, parking, traffic conditions etc. p P Y values, <br />);�- <br />-------------- <br />I <br />