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�� <br />A <br />�,�� <br />< � <br />� <br />� A� � <br />� <br />,, <br />, �,; <br />,� , <br />L����/���. � . <br />Cp�VIMUNITY' D�VEL.OPMENT DEPA�.tTMENT <br />2660 CIVIC CENTER D17IVE <br />ROSEVILLE, N�XNNESOTA SSiX3 <br />PiiONE: (b5x) 490-2279 FAX: (6S1.) 490-2931 <br />(City Gode xs available on the Internet; www.oi.�roseville.rnn.us), <br />SETBAC� PERMIT AP�LICATIOI�T <br />� �� <br />(CI'I`X CQD� SECTION 1013.0� <br />�, ❑ RES�AENTIAL PROPERT'Y OWNER. �E - $75 <br />' (All feea p���ble upon submittal of completed appaication) <br />Please complete the a�plication by typing or priz�ting in ink. If the spaces �rovided are insufficient, use <br />.� 'ad'ditiona! sheet�, keying infoz�ation to the psoper item nurnbers: <br />1. Name of Owner: (First) (Middle) (Last) (Phone) <br />�r,, <<-.� Sa�s� �.Q-s ( �-t� ���? 3 <br />2. Address of Owner: (No. And Srreet) (Cary) (State) %Zap) <br />��, ti c �, ) �i . �--�.,A ��.��e.._ �-'�� ��l f <br />3. Name of Applicant: <br />�V' <br />4. <br />� <br />(Middle) (Last) (Phone) <br />� <br />Address of Applicant: (No. And Streei) (City) (Sta[e) (ZiP) <br />)ol � ��..�LLc c � <br />Street Address of Pr erty Involved: <br />6. State exactly what as intended in be done on or w <br />� 7. <br />�0'd <br />reguires the setback <br />r.___�_.._ ,_�..,..._��..,,,n +L...* 1,.�.,�e l�oosa �Y�ri,>�a�,,�,h��h would enable vou to meet existing Code <br />� <br />Pagc ] of 3 <br />�0:6a 900Z—ZZ—JIdW <br />�� <br />