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� <br />� F:� <br />r,, <br />�� <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 1013.05) <br />;.: 4 r U ��'.Cj� —�._ <br />Cl RESIDENTIAL PROPERTY OWNER FEE -�-'�5�- ► � <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 />aciaitionai sneets, keying iniormation to tne proper item numners: <br />1. Nanze of Owner: (First) (Middle) (Last) (Phone) <br />�Q � � y�l/r►/ ��r,�� r-,C /., �--� )���,.�; <br />2. <br />3. <br />Add��e�s of OK�ner: (No. And Street) <br />Name ofA�plicant: (First) <br />G• <br />n <br />(City) <br />i <br />� a.P�vi, <br />�dd ) <br />-� . <br />4. A�'r�ss ofApplicant: (No. And Street) (City) <br />(State) (Zip) <br />��� s�%/3 <br />(Last) (Phone) <br />- �'� <br />(State) (Zip) <br />� <br />5. St�°eet Address of Properry Involved: <br />�G.�'+C <br />6. State exactly what is intended to be done on or with the properry that requi�°es the setback <br />permit: <br />_ �� ��,- ,-, �� , . -� � ✓ �-- i ` L`.�i4 r� U �. CG`Y w j�`tZ��� {�(� '�r��+ I V1 �, f i i �, <br />� --- <br />ll U� <br />, ii O Ir��IQ I� L J'Y�l�"1 !(�� �.r � lL,c. I�� t v� ✓LJLL,c.r J►'1 �`�� �.� � t' 1;� �ri J:-�'�,`.'� ,:`t �. <br />_ T <br />� , ` , i �;.�� �" i' '� t - ' 1� t. t <br />7. Explain alternatives that have been exanzined which would enable you to meet existing Code <br />��equirements: <br />� <br />Page 1 of 3 <br />I <br />