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���� <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 />.r., � �� �.. .P , <br />� , �� p,e�a:,�- ,_. <br />,'�l RESIDENTIAL PROPERTY OWNER FEE - $�5- , <br />' (All fees payable upon submittal of completed application) `��`' L'�"'"' k`' '`i <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 />� <br />F� <br />3. <br />4. <br />5. <br />6. <br />Name of O�vner: (First) (Middle) (Last) (Phone) <br />,�-l�E% h ��.i � C . � �'c �L-(.�"� (1% .S l ' t� Ll �l "" / � 7 � <br />Address of O►amer: (No. And Street) (Ciry) (State) (Zip) <br />1 j � Gj � (G �-� ���,�1 ✓4- ✓ C'- � • �i �5 c' v r � � )ly')/�' / l �� <br />Name ofApplicant: (First) (Middle) (Last) (Phone) <br />- � F �7�/' �Cz-/-,- �`E' � • � �G iC�'�- L� j l �� (v y �� � � � � � <br />Add�•ess ofApplicant: (No. And Street) (Ciry) (State) (Zip) <br />� � �`j ,� U � ��a'3'u'`�1 .�}�Oc, I�'10 • � � c� 5� lf � ( � -�. <br />Street Address of Properry Involved: <br />/ �� �- I � � �� �,�.�,�-� ./�� . i.�� . <br />State exactly what is intended to be done on or with the property that requires the setback <br />permit.• <br />-�_= "Ci�'� i""� -t=r ✓ :: .- <br />i <br />I ✓1 0 �G( � � r ; j%.�.C�m.o�.�{ ��" p f� � t t�C Vt1�.c..; I ►�1 � �� �'� i��P �'�-{— � � ° .:°�� i � �-� <br />; .— <br />b <br />� <br />7. Explain alte�•rratives that have been examined which would enable you to meet existing Code <br />requirements: <br />�'� �„ . 1 L �, �, �/ �-�/�1- l�i�. �"l � , _ -� 1'J. ,�� ,�.,�e „ __ <br />, <br />i . , �, �� � y ii /L% i <br />�b �'lc/Si �-� d?�Y" l''?�i'YrnP , L-1 <br />� pl/I / V�Pr,rj� ' <br />l(o ri'� O f�� ` d Q�P -� c. �i.. <br />Gj' G�t 2�i� a Yl <br />�J J <br />Page 1 of 3 �7`Lr�!7N� • <br />�J <br />