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� <br />�'��'i <br />�� <br />COMMUNITY DEVELOPMENT DEPART <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is available on the Internet: www.ci.roseville <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <br />���od� <br />MAR 2 7 Z007 <br />❑ RESIDENTIAL PROPERTY OWNER FEE - $75 <br />(All fees payable upon submittal of completed application) <br />Please complete the application by typing or printing in ink. Ifthe spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br />1. Nan�e o O►vner: (First) (Middle) <br />� -- T � i' <br />2. Address of Otivner: (No. And Street) <br />� �1 �a �'�5 � ��vt� r�'� <br />3. Name ofApplicant: (First) (. <br />S-�n �- <br />4. Address ofApplicant: (No. And Street) <br />5. <br />6. <br />7. <br />U,�l ;�' i <br />(C�h') <br />�� � <br />�dle) <br />(City) <br />(Last) (Phone) <br />�s%-�:�� -�i���� <br />(State) <br />�V����P <br />(Last) <br />(State) <br />(Z�P) <br />�1�� VL :�s � �� <br />(Phone) <br />(Zip) <br />Street Address of Property Involved: <br />�'� � t� ���-c. � � � l 1�s � �5�� � 1%l �% <br />State exactly what is intended to be done on or with the properry that requires the setback <br />nermit: . . � � � . <br />Explain alternatives that have been examirred which would errable you to meet existing Code <br />requirements: <br />rt%a� bllY,�r' a 1`t��� �- �-�1�4-���e � /Y�Pe-�- �u-�,�u� <br />Page 1 of 3 <br />