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<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 1013.0�
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<br />�., RESIDENTIAL PROPERTY OWNER FEE -$75- �� p �
<br />�' (All fees payable upon submittal of completed application) ���" '``'�'``'' '' {`�"��
<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.
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<br />3.
<br />4.
<br />5.
<br />Name of Owner
<br />Address of Owne�-
<br />(First) (Middle)
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<br />(No. And St��eet) (City)
<br />(Last)
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<br />(State)
<br />(Phone)
<br />(Zip)
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<br />Name ofApplicant: (Fi��st) (Middle) (Last) (Phone)
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<br />Address ofApplicaJ�t: (No. And Sh°eet) (Ciry)
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<br />Str-eet Address of Property Involved.•
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<br />(State) (Zip)
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<br />6. State exactly what is intended to be done on or with the properry that requires the setback
<br />pe�°mit:
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<br />7. Explain alte�•natives that have been examined which would enable you to meet existing Code
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