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� � � . . �""„�t <br />� <br />� ` <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, NIINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is a�ailable on the Internet: www.ci.roseville.mn.us). <br />CONDITIONALUSEPERMITAPPLICATION <br />(CITY CODE SECTION 1013) <br />❑ RESIDENTIAL PROPERTY O`��NER FEE - $150 <br />� BUSINESS/INDUSTRIAL FEE - $300 <br />❑ CITY PROVIDED PROPERTY OWNERS LIST/LABELS FEE -$45 <br />(All fees payable upon submittal of completed application) <br />Applicants are responsible for placing a City provided "NOTICE OF LAND usE ACTION" sign on the subject <br />property at least 10 days prior to the scheduled hearing before the Planning Commission or City Council. <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br />1. Name of Owner: (First) (Middle) (Lasi) (Phone) <br />Ro s e� I 1 e. .!-,�, d•� s i� .�..'� � e�-iti. �� L L C.._ <br />2. Address of Owner: (No. And Street) (City) (State) (Zip) <br />y90 o U�`IC�'^5, �r�.,e . Fci `�.�. , MN SS`!3 5� <br />3. Name of Applicant: (First) `(Middle) (Last) (Phone) <br />Sa .r~� - � <br />4. Address of Applican <br />N t(`r" � C o �ur p Q"�' � v <br />(No. And Street) (City) <br />(Zip) <br />5a ,�-� <br />S. Street Address of Property Ir�volved: <br />I b S� - I� 6(, TQ r r��� s,:�e ,�� s� .nS�.�. <br />6. Complete Legal Description of Property Ir�volved � PID Na (below or attached): <br />�Z-a.. �`���-ed �� 1�.�1 c r �P � �-- <br />: � aG� S �w� <br />7. State e�ctly what is intended to be done on or with the property that requires the conditional <br />use p�1i .S S wG n co r!� � �-1 � C� �•.� � � d S`I u'�' •+ <br />��-�-�f�-�.c.�� t�-�-e.,r -� R--,� p IG �.� f, d,,. ._.. <br />Page 1 of 2 <br />S <br />