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.... <br />`'',� , � <br />� <br />COMMUNITY DEVELOPMENT <br />2660 Civic Center Drive :• Roseville, MN 551 13 <br />Phone: (651) 792-7005 : Fax: (651) 792-7070 <br />ADMINISTRATIVE DEVIATION APPLICA <br />CITY CODE SECTION 1014.05 <br />www.ci.roseville.mn.us <br />1���0 �J� <br />s� p r� 2 zoio <br />�l APPLICATION FEE: $100 <br />Fee shot�ld be made payable to City of Roseville t+pon submittal of comp/eted application. <br />Please complete the application by typing or printing in ink. Use additional paper if necessary. <br />1. Property Owner Information: <br />Last nanie: � � �� �-- First name: _ <br />Address: � .� ✓ �� � � �� e- � l%^' "� City/State/Zip: <br />Phorre nzrn�7ber: �> ` �� ` '`��� � `' S / l Enaail address: <br />��� y.� �i j �- �c5 D1 Z., � <br />r <br />��> � �. ✓ �� �� �- <br />2. Applicant Information: (fdifferent from above) <br />Conipany nanze: `�... �',, ''�' �- �� 5�c_, /�c� �°-�,�� �.� s1 �— <br />Last name: �e ��'�� s o'�- First name: ��-�' <br />Address: � � � �} �.� �^ r [ �i � � � S Ciry/State/Zip: �1i � '�� ✓ ' °-'"'� �n 1 � � �I �. �> <br />Phone nzrmber: � % � -- �1'�'� `"n � � �J Email address: ��y ,I � 7"''''�K�N��`°`'s ,c ��'-- <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />L� e, S,,^ P l� �:. �.� �!� ✓� C' ` C� :. � e r 1, "`��' �,^ i� , i.� i:: t ,- l� �/ e r� > ��/ e_ /, n.�.L ���'" <br />/ —_ ✓ <br />6 .� �, � <br />� <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 />1) Include elevation drawin�s showing the proposed addition or new building with structure <br />setback deviation applications. <br />2) Include preliminarv 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 />§ 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 vour knowledge. <br />Property (hvner: � � �''�"�-/ � <br />Applicant.• <br />Date: � ( � <br />Date: l 1 � � <br />