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pf08-012
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5/28/2014 2:44:27 PM
Creation date
6/19/2013 3:42:13 PM
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Planning Files
Planning Files - Planning File #
08-012
Planning Files - Type
Setback Permit
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_.� <br />..� <br />���' E�, <br />� JiJ <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive •: Roseville, MN 55 ] 13 <br />Phone: (651) 792-7005 •:• Fax: (651) 792-7070 <br />SETBACK PERMIT APPLICATION ���� � u� <br />CITY CODE SECTION 1013.05 �A� � 3 2008 <br />www.ci.roseville.mn.us �, <br />� APPLICATION FEE: $75 �y"' '— <br />(Fee should be made payable to Ciry of Roseville upon submittal of completed applicatzon.) <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Last name: �� �,er��L First name: �r-Q�., <br />Address: =}Z � C_��,�1�,�- LQ,,h.Q, Ciry/State/Zip: �p��/j �� <br />Phone number: d�,�j'/ -/./ $�j - g�y g Email address: � �(.0 q�V � le %� !,� ry�G(i `, C1OIN <br />2. Applicant Information: (if different from above) <br />Last name: ,�i»ti.¢� First name: <br />Address: I City/State/Zip: <br />Phone number: <br />Ernail address: <br />3. Statement of Intent: Briefly describe what will be done on the property requiring the Setback <br />Permit. <br />�« o•. 5�10 dQ�arP �� ArPd-1� �oornn ru�.�►�i <br />�'hat w�,,T�� CX �'ev� v n i he �ee� i n%o �V �ro�l- Uard o� i'h i 5 �o nne �r- <br />� � k' 34 �e � ��nw� �'h�e �r'oht ti �t� i � v�e 6 �ee� �ram -1'�0 �a(,g. <br />4. Additional Required Information: <br />IJl u,� (J �oPert�y l �ln�. <br />a. Proposed Plans: A scaled site plan showing the existing and proposed building footprints as <br />well as driveways, sidewalks, and patios is required. Simple elevation drawings showing the <br />proposed addition or new building will also be required if the Setback Permit request doesn't <br />apply exclusively to a driveway. The plans for may be on 8'/z"x 11" or 11 "x 17" paper. <br />b. Written Narrative: The written narrative should address the 12 criteria that must be considered <br />during review of Setback Permit applications; these criteria are listed in the document attached to <br />this application and in § 1013.05 of the City Code. <br />5. Signature(s): By signing below, you attest that the information above and attached is true and <br />correct to the best of your knowledge. <br />Properry Owner: Date: �- p?- Q� <br />Applicant: <br />Date: <br />
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