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-� ---� <br />L�,,•/�-- <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive ❖ Roseville, MN 55113 <br />Phone: (651) 792-7005 s• Fax: (651) 792-7070 <br />���C����l� <br />.IAN :1 3 2u10 <br />By / <br />ADMINISTRATIVE DEVIATION APPLICATION <br />CITY CODE SECTION 1013.05 <br />www.ci.roseville.mn.us <br />�I APPLICATION FEE: $75 <br />(Fee should be made payable to Ciry of Roseville upon submittal of completed application.) <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Infarmation: <br />Last name: �P,��� First name: ����1 � <br />Address: �,�, "7L� �j,� ���� �, Ciry/State/Zip: �,�i� ���/,���� , ,/�j/f,�'J �, � �/.� <br />Phone number: ����—� `; �3� ��%�T fh. 1,1/C���c,' 1� � , _%�'' � �: � ' ,-�:r, <br />Email address: , � � . <br />2. Applicant Informallon: (if different from above) <br />Company name: <br />Last name: <br />Address: <br />First name: <br />Ciry/State/Zip: <br />Phone number: Email address: <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />i�:) ��:�� �1r(�{ T7�'"0 r�� �,( C l/;' S%�'', /(7 ,�'L i'-1 ti ���! �('� i�' t Qi� �� � .i l� J%i�Ci� .Fl i�C/��. <br />�. <br />�'�� <br />/�- <br />/'y°_ <br />I �. <br />4 % / <br />l <br />7 <br />1 ��7 �J / <br />^1� /�'''' i:>rOr"`=�f/.�� /�!�'f? .�ti' / .'C ���i�� i � /� �L_ �� !i��`� /J�i�"!C� <br />4. Additional Required Information: ��� � ,���; �„��,��!�,j,.�..,.��� .� ay��r �o -.���;���/���,,,;;��- <br />a. Proposed Plans: A scaled site plan is required showing the existing and proposed building `f� <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 qreliminary storm water miti�ation 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 your knowledge. <br />Properry Owner: ��,�%�'.�'`.'�' �� 2%+���-- Date: ' - �<� <br />Applicant: Date: <br />