Laserfiche WebLink
����� �� <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 />� r; <br />,0 RESIDENTIAL PROPERTY OWNER FEE -�5- �� P��_ �a <br />j ;- r�-., � �o, , '.'i <br />(A11 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 />, ,• <br />aGQiilGilai �I'ic2iS, ItZylil� iiiiOlillaii0il t0 i�1� j�I'd�,i:I' 1�EiT'. itUiil'4�CI'S: <br />1. Name of Oivner: (First) (Middle) (Last) (Phone) <br />�i�-�I,�c; h+� Lu�► llr i-I�-��;�I � (�S�-�yy-4938� <br />2. Address of Ox�ner: (No. And St��eet) (City) (State) (Zip) <br />�� 33 �. ��s�l���. � vE ��5�v; �►� rnN � s ► � 3 <br />3. ,��a»ze ofApplicant: (First) (Middle) (Last) (Phone) <br />�3�r�; n� Lv� ► �L E �-�a-�-��,��Id l�5 �-�4-�v��y93ff <br />4. Add�-ess ofApplicant: (No. And St�°eet) (Ciry) (State) (Zip) <br />I '� 3 3 �,�; , `=}< <br />5. Street Address of Property Involved: <br />nN �}�`° - �,D.Se�I� Ilr <br />NSS�� <br />�� 3� l,t� _�� t� S�E �- A� N A� C 1��5 � V i L L� , j1��/1I �t� ( 3 <br />6. State exuctly what is intended to be done on or with the prope��ry that requi�•es the setback <br />permit: <br />_, .� f <br />_�____ .��:...i '� r � , . -r-c'✓ '._._ ; `� ' 4 �('ifit � C.Cir i.il j`t�a� c.'r-t rl �1.A ;�1�4c . �( i %� . <br />� �,.� .}- y ,y � ,/� <br />�Z i% 1�✓�•' � i j � :� 1 i.n-l� ��r/+ /t.t:.. � i� i l�Ut �t.i..'✓! { 1 1 ,, �� � I �( � � � f..'r;"`t ; �?».r _ � : j , <br />r <br />i :� � s r �is<',--�.,.C`�✓� - '� �,�' t i l `:+y. �' � - i - i.� . .� ��� � w.% 1 .-.. <br />1 <br />7. Explain alter»atives that have been exan�ined which would enable you to meet existing Code <br />repuirements: <br />' r�., _ fi 1--1/ _ n J — 9 _ • / U _ n . 1 ►� l A-- ..-1-- . � <br />Page 1 of 3 <br />