Laserfiche WebLink
-. <br />� <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive •'s Roseville, MN SS I 13 <br />Phone:(651)792-7005•'r Fau:(651)792-7070 <br />SE'IBACK PERMIT APPLICATION <br />CITY CODE SECTION 1013.05 <br />www. c i. rosevi I l e. mn. us <br />e <br />� APPLICATION FEE: $75 <br />��C�Ory�� I <br />JUL 21 �,�i;3 i� <br />� <br />(Fee shou/d be made payable to City oJRoseville upon subminal ojcomp/eted application.J <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Last name: N t' �sc,.� First name: (3 u v1 `� �� f I�,� i�v� <br />Address: �� �,>,�}�h,�rG� l�f ��Vl' City/State/Zip: _�{USev� ��t� mN ��i �13 <br />Phone number: r,5 � 1��0 �S 3lo�j Email address: Y1C�,�k,n �c,w;i �.� OU7 ��-�:�wtit. �,e <br />2. Applicant Information: (ifdifj'erent from above) <br />Last name: � � � � pV u First name.• � �,�� <br />Address: ZS�<; 1-�ah��rrn. 5'� City/State/ZiP 111_ oT�Ncx,�� m7, jS �C�l <br />Phone number. (� (2 (�°:� (�L q Email address: 11'la +f C��� �:�:, hc �+�c�s c t++� <br />3. Statement of Iutent: Briefly describe what will be done on the property requiring the Setback <br />Permit. <br />�='�'`''���D .��J`�'+� � w- �I-� ex+o�, � +�, �.,-+l� ��, 5 ` . { <br />4. Additional Required Information: <br />a. Proposed Plans: A scaled site plan showing the existing and proposed building footprinu 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 drivewa}'. The plans for may be on 8%:"x 11" or 11'k 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 aze listed in the document attached to <br />this application and in § 10 ( 3.05 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 />Property Owner:,�E�7`J .� ,'�,/ �CV' <br />, ., <br />Applicant: ��� �,r��;;,rr„ <br />Date: {-� -�' �O�_ <br />Date: ��,-2Ci —C��i <br />