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i. <br />I i <br />t�1, <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 />❑ RESIDENTIAL PROPERTY OWNER FEE - $75 <br />(All fees payable upon submittal of completed applicatioo) <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. Name of Owner: (First) (Middle) (Last) (Phone) <br />� • <br />I�w; w«-e� �sse�.� tx� (- �I�� -��s�� 3 <br />2. <br />3. <br />Address of Owner: (No. And Street) (City) <br />' �I <br />�G � � � ��;. <br />Name of Applicant: irst) (Middle) <br />S��v�� <br />4. Address ofApplicant: (No. And Street) <br />I �:% 1 � � �-z., <br />5. Street Address of Pr erry Involved: <br />(Ciry) <br />�� � �� � <br />(State) (Zip) <br />�� � �� l l�3 <br />(Last) (Phone) <br />(State) (Zip) <br />o � .:, �� i 3 <br />\ �J � � a�,�. `-1�� ���:�-t-lE , lJv , �,i.s� i,��.-� � ��� _ �_�,� <br />6. State exactly what is intended to be done on or with� properry that requires the setback <br />perm \` �� 1� 1`t- V, i�,�"�, �C.1 G- � Jti�.�►� ��., � l�' l 1 I, �.'� U� _, <br />QSS <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements� � , n, (J �, i i �i I 1 . � - �� <br />Page 1 of 3 <br />