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Last modified
5/28/2014 11:40:39 AM
Creation date
7/3/2013 10:53:53 AM
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Template:
Planning Files
Planning Files - Planning File #
3733
Planning Files - Type
Setback Permit
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0�/23r''2�05 13:27 6517927040 ROSE'��'ILLE ENGINEERIN P�GE 02 <br />j�s�� : -�P�tit- �% <br />��`� <br />COM1V.[UNITY DEVELOPMEN'�" DEPARTMEN'I' <br />2660 C1V�C CENTE� DRIVE <br />ROS�VILLE, N�IlVNESOTA 55113 <br />�HONE: (65�) 490-2279 FAX: (G5X) 490-2931 <br />(City Code is availablc on tl�e Internet: �vw��.ci.roseville.mn.us). <br />SETBACT� PERM�T APPL�CATION <br />(CT1'Y CODE SECTION 1013.0� <br />� � P �- r <br />RESIDE�'IAL PROPER'I'X OWNER FEE -�5- G � <br />(.�,Il fees paynb�e upoo suhppittal of com�[eted applic�tion) �� �k'`� V� <br />Please complete thc application by typzng or printizzg in ink. �f thc s�aces provicled are insufTicient. use <br />�-!�C�'i'1^';:�? 3�:_�':'S, ��J'.:3� ir,�v^aiZ'AU�iOil i'v iii� j7iu}7tr iielTl flUmbers: <br />� 1. Name of Owner <br />.'r <br />� <br />.� <br />,, <br />; <br />Address of Owner <br />�Z � 5. <br />Name ofApplzcant <br />�,�'-TYSIJ <br />�G �l � <br />(Middle) <br />hone� <br />5 . ����F ,, ,`'�� 5�) �� � S " J��� � <br />(i1ro. Ar�d St��eet) (City) n (Stcrte) .�.; (7ip) <br />Ca����ss� � .�1�,°��'� , ,r� �5�=,��, /%, ��J .�S%13 <br />(First) (Middle) (La,rt) (Phone) <br />�7 4. Addre�s ofApplicaMt_ (No. At2d Street) (City) (State) (Zip) <br />i' <br />•, . <br />��r <br />6. <br />I� <br />St►•eel Address of Property Involved: <br />Sta�e exaclly wl�at is inre�ded to be dor�e on or witlz [he property that reguires the setback <br />permit: <br />F�plain alternatives that ha�:e been exarrain�ci,��hich wo�ld enab�e you to meet existing Code <br />requirements: . � <br />i/�,�� �s .� � re� l>.s h c.. �% n<<fi ���,✓, �'C�� �� f�t'��v, - <br />LL� ✓J <br />vuui�y fj'('�S <br />.� <br />�✓dc'tG�� Ca /Ltd,�t�r- �1;// Ctr�(�� j���Crt' <br />� , <br />Page 1 of 3 <br />� <br />
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