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-�;. <br />r° -;e <br />��{�X�;�'�� - � �� � <br />�si � <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 />� : ° t � � �:�.,t�- . �.o <br />G1 RESIDENTIAL PROPERTY OWNER FEE -�- 0 <br />` (All fees payable upon submittal of completed application) ��''{.' ' •�" b� , <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. <br />2. <br />1Va���e of Otiti�ner <br />a <br />�lddress of Oti1•ner <br />(First) (Middle) <br />�; �. � � I1; <br />And Street) (City) <br />4��s�.l �, �4 w W <br />13 �,'1 <br />3. Name ofApplicant: <br />� ut <br />4. Add�•ess ofApplicant <br />(First) (Middle) <br />��l{,'.�. J� ��,11 �� <br />o. And Street) (Ciry) <br />5. Street Address of P�°operty <br />I �3L`1 <br />6. State exactly what is intended ; <br />pe��mit: <br />(Last) (Phone) <br />, �s�- �ya- �yy� <br />tate) (Zip) <br />a��, �� 55 �r� <br />(Last) (Phone) <br />�5�- �ra- ���+� <br />tate) (Zip) <br />�n�. v�ll� �� s5» <br />� �ww�, �.c� � � 55»3 <br />done on or with the property th requires the setback <br />, -- m' %' '1�' " � �a - , . � �- C..UV � � <br />, <br />_ � i/t v I�t,� � � � �L(LLLM ��1;,� Q i VC t�JLL,c,� 1 1� ��=—�,� r : � � � �,,_.i_ - ; .,,, ,• `"+ <br />, <br />� ' <br />, ..._ , r ' ' � <br />r ',� i � � 4 �.u:��„+ '' '✓C�t � %'� ���1 �'^ -�. �� � . �,. ` � . <br />� � r t i� <br />7. Explain alterrtaj,iu�s that have been examined which would enable you to meet existing Code <br />requirements: � � <br />Page 1 of 3 <br />