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r <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 />1. - C�-r7u 11. <br />ame or owner: (First <br />e <br />ast Pane <br />2. <br />Address of Owner: No. and Street City State Z p <br />3. <br />(dame or Applicant <br />4 . 1.0 �a 4 <br />rst lc, <br />ast <br />Address of Applicant: (No. and Street)---ity tate p <br />Street Wddress o Property Involve <br />6. Complete legal description of property involved: <br />7. Date Property Acquired:.T , <br />8. Present Use of Property: Proposed Use of Property: R-1 <br />9. Present Zoning of Property: R- I Proposed Zoning of Property: R-1 <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 />