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1�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 [nternet: 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 application) <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 <br />2. <br />Name of Owner: <br />�� c�ar� <br />Address of Owner: <br />(First) (Middle) <br />lnlilli'a�, �odvi� <br />(No. And Street) (Ciry) <br />(Last) (Phone) <br />� �i- � �q-o�b z <br />(State) (Zip) <br />!�o � � �emac�. � t'i� v�e � ��se VI� ��e �N �s � � 3 <br />3. Name ofApplicant: (First) (Middle) (Last) (Phone) <br />1 � f C.�Ci � v V� �I ��Q %1�) �� 1% i✓1 <br />4. Address of Applicant: (No. Arrd Street) (City) (State) (Zip) <br />�R �" l �rrac���� Ve. ,1S�vi ��e d�/� � �"�� � <br />5 <br />6. <br />�� <br />Street Address of Properry Involved: <br />� � T�rrac� �ri Ye, ��v�Ul �. �VII� � ��� 3 <br />State exactly what is intended to be done on or with the property that requires the setback <br />per� �it: , <br />� d�I� �'i a n a`F a secovtci c�a rc�q e o`� sa vn e s i z� <br />-t�a c� rr�.nf � r r,g 1e- -�v�k - v nde.r�a �c�e. <br />Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: . � <br />�ed-uci r�c� s � z� o� g a►rr�tc�� a�� a n o�i s�vas v�r�`� <br />i � i� <br />ac��e� l,� b eca �s� c�c� v�q I�eKss -ti�ta n Q 9'x �' c�r <br />o pe�4l r1 q�•Jov Id ma k� �1 e Ctc��! ov( <br />�a� � <br />�� 2�C ( S�7�vl O P-yl 1 Vl G� i't Cl i�a.q l�p'�'�-��OrC� V�-II) C�� <br />Page 1 of 3 <br />