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� <br />�� ,, <br />.��✓ <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 Civic Center Drive •:• Roseville, MN 55113 <br />Phone:(651)792-7005 : Fax:(651)792-7070 <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <br />City Code is available on the Internet at: <br />www.ci.roseville.mn.us/council/city_code.htm <br />s �u�� <br />�� <br />�V/V <br />�41��� � <br />¢ RESIDENTIAL PROPERTY OWNER FEE: $75 <br />(Fee payable to City ojRoseville upon submittal of completed application) <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 />Name of Properry Owner: (First) (Middle) i(Last) (Phone) <br />%�mq_5�f �Qmc.la � ����� �-►�55 G�.��%-,3.��-�,�3� <br />2. Address of Properry Owner: (No. and Street) (City) (State) (Zip) <br />oZ L� l� t-r� ,5'1 �, _�,�� v �'1( e_�1�1/ .ssy/ <br />�.� � iiiK�:'l:�+r,:�rY�u <br />3. Name ofApplicant: (First) (Middle) '' " (Last) (Phone) <br />��errns �-�dr��e �-2�S �57-33a-��3� <br />4. Address of Applicant: (No. and Street) (Ciry) (State) (Zip) <br />� � �J �'� S� � 1°�QStV� ��l 1�'�� <br />;, ` <br />Street Address of Property Involved: <br />�� 1,� � <br />7. <br />N <br />State exactly tivhat is intended to be done on or with the properry that requires the setback <br />permit: <br />� <br />m• <br />Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: ' .:Y:. ; <br />Setback Permit .lpplication Page 1 of 3 <br />