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-� ---� <br />l�s <br />�� <br />COIVINIUNITY DEVELOPNIENT <br />2660 Ci��ic Center Dri��e •3 Roseville, MN 55113 <br />Phone:(651)792-7005 ❖ Fax:(651)792-7070 <br />ADMINISTRATIVE DEVIATION APPLICATION <br />CITY CODE SECTION 1014.�5 <br />www.ci.roseville.mn.us <br />❑ APPL1CATlON FEE: $100 <br />Fee should be made payable to City 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 lnformation: <br />Last name: u r��`f� <br />Address: L-�1 i� Vl�(Oi2/�Q S'T <br />Phone number: �'` �� � �=S � ` ! 7' �� <br />First name: �'\`� y <br />City/State/Zip: ���V'i c{ ��� �-C !;-� <br />Email address: �'� �'�e `'�'T �''J� � ���'� 1' ' �A�`^ <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 lntent: Briefly describe the project: why is an Administrative Deviation needed? <br />/`�v !�%N/��� i� �,'K./�!/r�l�/r' y / l� K��Y�I � �^<�' �Jf ./ i r.J� ✓� L -- � �1i,1'�� / �!-�l���l<,^i � L` 'iJ�.r <br />S�?/3,�nJ���' �R� /NIRZS'�';� _-� T% //��/AJT,C!N. it/EI�� /�,��✓/i�� �J����' �r �?r <br />f � „ � , �, <br />/ �- ,� �e,r� �_ -,� f, � <br />4. Additional Required Information: <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 />l) Include elevation drawin�s showing the proposed addition or new building with structure <br />setback deviation applications. <br />2) lnclude 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 />§ 1014.05 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 />,,/ / — (7 <br />Property Owner.• ���' �- ��'' Date: `�` � � <br />r � <br />Applicant: v�`�'� Date: <br />