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����� ' ,- � _ ,. <br />�-�� <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is available on the Internet: www.ci.roseville.mn.us). <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <br />. �,� ;-� P,e��-- _ <br />,�1, RESIDENTIAL PROPERTY OWNER FEE - $�5- <br />° (All fees payable upon submittal of completed application) ``��P`" �' `''��'�' '``"`'''l <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. Na�rre of O►a�rTe�- <br />2• <br />3. <br />4. <br />:� <br />6. <br />(First) (Middle) (Last) (Phone) <br />������/�'.�'Y /_ � ���/�� �✓�j " 4t !��"7�TC%!`� � <br />k � <br />Add�-ess of Oia���e��: (No. And Street) (Ciry) (State) (Zip) <br />t` ��� �/� iN/; �� ���1:/ti' �S i - /�;' ������' <br />,'��ame ofApplicant: (First) (Middle) (Last) (Phone) <br />,,. <br />t� , [ �; <br />Address ofApplicar�t: (No. <br />�,; <br />Street) (City) <br />�3 .�'% �.��:, �!'�%'i�-sSC� �.������Q i�� <br />Street Address of Piroperty Involved: <br />��/ L � �5'%/ ,� - � / � � <br />(State) (Zip) <br />Stute exactly what is intended to be done on or with the �roperry that requires the setback <br />pe��mit: <br />� � „►r � kr 1 . !1 ., . . ,, .,, � I n =i..� <br />'� r`� lii�c".�f:+C 1f� j(�C.(iJY1.b Ir?,�r� 1 rLc.. � j( t'vi..V' '' ,c.� I r�� a r�tC� l,L�i 4' -� �;"� i. - 1��r`.. �; i i;r �; <br />,�� ._� 1'..,___ <br />7. Explain alte��natii�es that have been examined which would enable you to meet existing Code <br />requiremen� <br />'� �l/I:s c�:,��� c�/��-► ��s �Gns �r�c� ��c� / � % j�/¢�> %�✓�/�v�i��� <br />��hc �e�,,�e Uc�� �c:�, �`�5�, � w�t,/l � �t�.�1s�r� <br />; �� t4 � <br />_ �. ;v <br />Page 1 of 3 <br />f� C� Y� ��c� w� <br />