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i. <br />11. <br />12. <br />b. List�^�-����-�r�a� ___.... r�.. �....,_ ..�__�.i-guo�tts��epe�k� e��er. � � .. : <br />�� _: <br />c. .��ese�-�l�rr-(�-eo-pre�s-}-t��rg-��g--pla�, landscape plan, grading and drainage <br />plan and exterior building elevation drawings showing buildings. Such drawings <br />shall be 8 1/2 x 11. �':��`.'' -�"C ==�:z� :. -- <br />� <br />e. <br />Narrative: Attach an explanation of why this permit is needed, the resulting <br />impact on the neighborhood, and responses to items 9,10, and 11. <br />Other documents as requested by the-�t3��-����. <br />It is not necessary, but helpful, for the applicant to attend the Development Review Committee <br />meeting to clarify issues. <br />Note: The Development Director will make a decision and notify the applicant within seven (7) <br />business days. <br />Signature: The above statements are true and correct to the best of my knowledge. <br />Applicant Signature: j% <br />Property Owner Signature: <br />� <br />Date: � " ?- � � <br />E-mail Address: <br />Phone #: �G �i�' � `� �� Fax #: <br />i ;� , �s �s �- -�-� �z� �_ . . F , , , ""'"� �� . <br />; ,` <br />r.�.: - .� <br />�-�,�-�}� �-'-� r ,,av 3^� . <br />� � �9 '`� �,�� � i _,< . <br />V <br />��o�o � U � � C' <br />�o�e�v i 1��e , M-tJ <br />�. �. k �'. �.� �� e �r._ a s �:�._ <br />; t_ , -� <br />Revised December 9, 2005 <br />\�netro-inet.us�Roseville\CommDev\PLANNING_AND_ZONING\Application Forms\Setback Pem�it Application\Setback Permit Application(2006).doc <br />Page 3 of 3 <br />