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Case <br />No.: <br />CIr1Y OF <br />ROSE <br />2660 Civic <br />Center Drive <br />Please check item or items for <br />which you are applying: <br />Pzn g <br />$100 <br />Division of Platted i�at <br />$ 50 <br />• Special Use Permit <br />$100 <br />Pelocation of Dwelling <br />$ 50 <br />Vacation of right-of-way <br />$100 <br />Variance to zoning ordnance $ 50 <br />Preliminary & Final Plat $100 _/Mi nor Variance $ 25 <br />Please cc:xplete 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 />-44 <br />Name of Cwner: First (Middle Last PhoneT <br />2. e-IA EG DR. fib SEVI CL it in / /VA/. <br />Address of Owner: No. and Street) (City) (State) .'� (Zip) <br />• 3. ! C. /Av/Ec:: S <br />Name of Applicant: (First)(Middle)Last (Phone) <br />4. &06 5E 3 <br />Address of Applicant: (No. and SERet) (City) (State) Zip <br />5.5 9 fiE /N� c Die . <br />Street Address of Property Involved <br />6. Ccnplete legal description of property involved: f l e s7' , C y 7� 4e of ol- <br />t0imp1,l- __ - p k l 1 tl 6 ,% •� n Qe <br />7. Date Property Acquired: M6 5 <br />8. Present Use of Property; qNe FAII Hvrhe Proposed Use of Property: 6prE F m Ma E <br />9. Present Zoning of I'ropas•ty: - ,J Proposed Zoning of Property: / <br />10. Mat plan or change makes this request necessary? ex e- h :5 , e <br />eX i 5"f•i hn ��9LajP -- <br />11. What is the ex-pected effect of the proposed c,`hange? (For exarple, on property values, <br />health, safety, parking, traffic conditions, etc.) lJ 0 0 E <br />t <br />t <br />