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—. -� <br />1�� , <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 •'r Fax: (651) 792-7070 <br />Q)������ <br />OCT 0 5 2009 <br />ADMINISTRATIVE DEVIATION APPLICATION <br />CITY CODE SECTION 1013.05 <br />www.ci.roseville.mn.us <br />❑ APPLICATION FEE: $75 <br />(Fee should be made payable to Ciry of Roseville upon submittal of completed applicntion.) <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Last name: /�f G( ��(/ j,��� First name: �/J/%iS <br />`T � <br />Address: ..Z9�lp 12�i/2� �ij . Ciry/State/Zip. �,f{v/��il/ ��//� <br />Phone number: li f"/ �.�2. ���3 Email address: ����.� � G]MQ� ���, <br />2. Applicant Information: (if different from above) <br />Company name: <br />Last name: <br />Address: <br />Phone number.• <br />First name: <br />City/State/Zip: <br />Email address: <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />� <br />� <br />4. Additional ReauirecCI <br />a. Proposed Plans: A scaled site plan is required showing the existing and proposed building <br />footprints as well as driveways, sidewalks, and patios. <br />1) Include elevation drawings showing the proposed addition or new building with structure <br />setback deviation applications. <br />2) Include preliminary storm water mitigation plans with impervious coverage deviations. <br />b. Written Narrative: Address the factors that must be considered during review of Administrative <br />Deviation applications; these factors are listed in the document attached to this application and in <br />§ 1013.05 of the City Code. <br />5. Signature(s): By signing below, you attest that the information above and attached is true and <br />correct to the best of you�owledge. <br />Property Owner: <br />Applicant: <br />Date: �'� a� � <br />Date: lO�o s'� <br />