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��'� _ , , t u .� <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 />_; ; �� � �, i�L�t- — <br />,CI RESIDENTIAL PROPERTY OWNER FEE -$�5- o <br />' (All fees payable upon submittal of completed application) `�'�"°' ''`� �`�A '' ``��'�`�,� <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />a�?�i±ional s?��.e±s, keyi:�g inf�rrma±i�n to the proper i±em numbers: <br />1. Na�ne of Oivner: <br />J r� m <br />(First <br />� <br />) (Middle) <br />C��n ���C <br />�2 <br />(Last) (Phone) <br />2. Address of Ort�ne�•: (No. And Stree ) (Ciry) State) <br />�`��'7 � S�lia ���' /'� i�' �V lf�l' �ti'i/[ % <br />3. Name of Applicant: (First) <br />��� �� � �i C � rn <br />4. Add��ess ofApplicarrt.• (No. And Stre <br />l�2 �'I ���e%3�N /� <br />5. <br />6. <br />.; <br />� .� <br />7. <br />(M' dle) � <br />0 /� � 2 <br />(Last) <br />t) (City) (S <br />��u� ,��;// <br />�� <br />�s"i-� �� -%��� <br />(Zip) <br />l/ �-'s'//.� <br />(Phone) <br />�s�-,���-iy�0 <br />iZIP� <br />/�� �.�//.� <br />Street Address of Property Involved: <br />I `l2% �� �e I � �r�N ��� ��� /C� �cfi � /L� S�//� <br />State exactly what is intended to be done on or with the property that requires the setback <br />�Jel"19ZZt: <br />_�_ �✓'�€°'� r v�"� ---; ',! _ L�? l�!n IC,E C. C�1' i.cl 1`�l�t,CXTI� ��s! I Y'� �. � i r. <br />� V 1 D �G� � � i!) �I rm �'�% ,� " l il�. ! i � i ;.� 'r' '�L,�.6 f 1'� `� t ° ° - � 1, `' `� p�i�"°r°t i �_���.'l,'i'� �: ��. <br />Explain alte�•natives that have been examined which would enable you to meet existing Code <br />requirements: <br />Page 1 of 3 <br />