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� <br />.-. <br />tt���'J►.. � <br />COMMUNITY DEVELOPMENT DEPARTMEN <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 />D�C�L�� � <br />� NOV 0 5 2007 <br />❑ RESIDENTIAL PROPERTY OWNER FEE: $75 <br />(Fee payable to City ojRoseviCle upon submitta! 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. Name of Properry Owner: (First) (Middle) <br />� ������ � �/�s-i�e� <br />2. Address of Properry Owner: (No. and Street) <br />=�`� � �%j �'7�'I Lc� ,S f <br />3. Name ofApplicant: (First) (Middle) <br />,���'���� � �i: <br />4. Address of Applicant: (No. and Street) <br />(City) <br />5. � Street Address of Properry Involved: <br />�-� ��`�''] �%l C �ia- S� /C�, <br />6. State exactly what is intended to be done on or with <br />permit: ,' <br />r <br />, <br />: �h c? � ' <br />� �l �J .��'� �� � , <br />(City) <br />(Last) (Phone) <br />� �/--- y�-� -��� ���. <br />(State) (Zip) <br />. „ , <br />(Last) (Phone) <br />� �/� /�� _od <br />(State) (Zip) <br />���- /il'�.t�.��'%/ <br />property that req` uireslh��etback <br />�� <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br />Setback Permit rlpplication Page 1 of 3 <br />