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rj <br />J <br />��!i� ... ' . ,,. ` •. <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 />.:�� �t,� Peo��- �- <br />��1,:; RESIDENTIAL PROPERTY OWNER FEE -�5- r <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. Na�ne of OK�ner: (First) (Middle) (Last) (Phone) <br />,������y �� y,��= �y�_� ���� <br />2. Add�•ess of Ox�ne�•: (No. And Street) (City) (State) (Zip) <br />/ �/�-�.S �G%,S � ���,�/ �GS� �/iG C � <br />3. Na�ne ofApplicant: (First) (Middle) (Last) (Phone) <br />/� ��'�'Y c�c y�� ��s � ��G. <br />4. Address ofApplicant: (No. And St��eet) (Ciry) (State) (Zip) <br />/ �_��� %�G S�«�i� �G` S�vi `� �- <br />5. Street Add��ess of Properry Involved.• <br />� s �/ //1 � S � «}C��✓ �f �'�� (//« L- <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br />vv i'�.1 F"_ (� <br />���.��� �"� � I S %,t r1 G� (�,�. CAY w .r C.Y-t!� A`'�e�' Ct_G 4 <br />` � l,,.� #� � ' ! I � <br />iJ � vt � � l � '� � � i Yf, t�—�� �� Iv' Y� 1�..+'J i°� I Cis��,L. ° i iJ`Y i <br />{� <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br />�� �, <br />Page 1 of 3 <br />� <br />