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} <br />- <br />I <br />CITY OF <br />ROSr—,MZE Case No. <br />2660 Civic <br />Center Drive <br />Please check item or items for <br />which you are <br />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 />Vacation of right-of-way <br />$100 <br />,Variance to zoning ordinance <br />$ 50 <br />Preliminary & Final Plat <br />$100 <br />Minor Variance <br />$ 25 <br />Please ccaplete form by typing or printing in ink. If the spaces provided are insufficient, <br />use additional sheets, keying information to the proper item nut ers. <br />Namur <br />"�'� 7 <br />of C�rmer: F�.rst <br />_ <br />(Middle <br />(1 <br />Last Phone <br />Address of avner: (No. and <br />Str t) <br />(city) (State) (zip) _ <br />3 <br />7 Date Property AOqui ed: ! % <br />8 •ese_nt Use f <br />o0r7E'= Proposed Use of Property: <br />11 t^Tnat is the eX:pected effect of the proposed cimnge? (For er , <br />.arple, on property values, <br />health, safety, parking, traffic conditions, etc.) <br />LZ <br />i' <br />