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-� <br />-� <br />1J� <br />y.. J <br />COMMUNITY DEVELOPMENT DEPARTMENT <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 [nternet: www.ci.roseville.mn.us). <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <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. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br />1. Nanze of Owner.• (First) (Middle) <br />�u 5-ZLo <br />2. Address of Owner.• (No. And Street) (City) <br />/dS0 Sti e � ��^ ��� l�l S{ v7' i%Q <br />3. Name ofApplicant: (First) (Middle) <br />,�a ��-�c� <br />4. <br />s. <br />6. <br />Address ofApplicant: (No. And Street) (Ciry) <br />/c� ; o S�.��r�e� S f� �s � �,�//� <br />Street Address of Properry Involved: <br />�� � �P���q S� <br />(Last) (Phone) <br />�dv,� <br />(State) (Zip) <br />�N 5�//3 <br />Last) (Phone) <br />e�o � <br />(State) (Zip) <br />�-/p(/ S S // 3 <br />State exactly what is intended to be done on or with the property that requires the setback <br />pernait: y/��1 �6� C.� 9' C(JLec C�Q �uv� �OGZGK Gr'T � <br />/ <br />/�w/ <br />, <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: -T <br />/l�-ie an.� � � �i�i�� 'r� czu�c�.��� , <br />7� <br />� <br />> �'�� <br />O� `� �� �a� _ <br />Page 1 of 3 <br />� <br />z � <br />