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r.: <br />(`t�'�, � �, ' �_ � <br />�� � <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 1013.0� <br />_x., � p,�d:,�- -- <br />.�1, RESIDENTIAL PROPERTY OWNER FEE - $�5- �. <br />�` (All fees payable upon submittai 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 itein numbers: <br />1. Name of Owner <br />(First) (Middle) <br />�n l�-����� <br />2. Address of Owner: ((�VVo. And Street) (City) <br />(Last) (Phone) <br />GSl E�1 i�� <br />(State) (Zip) <br />I �,�� � ���1 .�P f�'� 1�6�— <br />3. 1Vame ofApplicant: (First) (Middle) (Last) (Phone) <br />Je�e �/- ltiu.�� .� �Si ��� �v l� <br />4. Address ofApplicant: (No. And St�°eet) (Ciry) (State) (Zip) <br />�3�� ��1��� <br />5. Street Address of P��operty Involved: <br />1.��'� ��ir��l <br />e u�,� U/P� <br />��� <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit.• <br />��-=-'�-�'� � ��� = I S L� �n �n I�¢. C.C1v � C'�t,t_c:�-r'�� �t '�'r1 � � t i <br />�t : I ..._ _�t � �. . _ � � � � li ' + , <br />, � . .. i � <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: �--� •/ ( ��, <br />I ��-�l l�� f�l/lA� /� �7 ��ir/.�i� J?� "'74'�-(� l��f/il�l 9 <br />��� �`�� <br />Page 1 of 3 <br />