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/ <br />_„ <br />� <br />''1 <br />� <br />� � . . � <br />��� ��� �J LJ .JL <br />�;� . <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 Civic Center Drive •3 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/co uncil/city_code.htm <br />❑ RESIDENTIAL PROPERTY OWNER FEE: $75 <br />(Fee pni�nble to City of Roseville 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. Narrze of Property Owner: (First) (Middle) (Last) �� ; � % (Phon�e) <br />, <br />����i" F� � ��� " � _�Li/� �i��. i� �'� ;�-1 � //1�� ��O � � % > � � <br />2. Address of Property Owner: (No. and Street) (City) (State) (Zip) <br />. _ � �r / _ <br />�i �� � � l �(����/ �ltl� ,CFf�yl�{� %�l/l,� � `���� <br />3. Name ofApplicant: (First) (Middle) (Last) (Phone) <br />4 <br />5 <br />� <br />�_ <br />Address ofApplicant: (No. and Streei) (City) (State) (Zip) <br />Street Address of Property Involved: <br />�C '�?� �-��ll't/I ��i ���U��l f�C`S=!�(;i� <br />State e�-actly what is intended to be done on or with the property that requires the setback <br />perntil: <br />� / . <br />� ���LI�I t�/J���''�"i(-' �,�G',-���; !`� C't"7-7 � /��� l2 ��,�iC>��` <br />7. Explain alternatives that have beerr examined which would enable you to meet existing Code <br />reqz�iremerrts: <br />���� � y j �, . � �' ��.�' v"/�/'l �7l/� S' � E�/���1 y' � � r J �', ���� <br />/��d;��-� �, r� ln� � , . <br />Setback Perinit:�pplicarion Page 1 of 3 <br />� <br />