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� '�� ! <br />1�'• <br />�� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 ❖ Fax: (651) 792-7070 <br />p L�C���d[� <br />�� <br />� AUG 21 2009 <br />ADMINISTRATIVE DEVIATION APPLICATION <br />CITY CODE SECTION 1013.05 <br />www.ci.roseville.mn.us <br />❑ APPLICATION FEE: $75 <br />(Fee shou[d be made puyable to City of Rosevil/e upon submittal of completed application.) <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Lastname: ��cob�s Firstname: j�c�n;Sc�. c.end- 1�zn��e- <br />Address: aU(,D C�swcr^�I� Cou r t City/State/Zip: �Ros�v� Ilt� !�I'1 �✓ S s//� <br />Phone number: �� 3- 5�� - 7s �� Email address: oran- ��acob�s o� eob�+casf,h e-1- <br />2. Applicant Information: (ifdifferent,from above) <br />Company name: <br />Last name: <br />Address: I �� � Snnsbr�cJ� +��rlc <br />Phone number: <br />First name: <br />City/State/Zip: C � I u rn b; a. i�� � yh �S �'i�nJ .SSS��/ <br />Email address: � <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />o� �% �u �o5y'. ff) Gti�er ullowabl-e, ,m��rv�v�s jrl1u:f.�r;aP Dn Rew bv� Id- W�= <br />a r-� i yls-�al� r n 4 a ra r n� a r�-e�, i h+h� ba� �C v-F �h.t 1 o f. T!� �/v f c�; �� b <br />q rc�a �+� �, rP�+ r �n off f o �{-i, e��� � h �i a r<J�h . <br />4. Additional Required Information: <br />a. Proposed Plans: A scaled site plan is required showing the existing and proposed building <br />footprints as well as driveways, sidewalks, and patios. <br />1) Include elevation drawings showing the proposed addition or new building with structure <br />setback deviation applications. <br />2) Include preliminarv storm water mitigation plans with impervious coverage deviations. <br />b. Written Narrative: Address the factors that must be considered during review of Administrative <br />Deviation applications; these factors are listed in the document attached to this application and in <br />§ 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 />Property Owner.• �/-P/iZ�*-c- Date: ����- �� 1 <br />Applicant: /)� �Ul.l�Y%G�� Date: � � °�� - � � <br />