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-� <br />�- <br />�� <br />COI��IMiiV1"CY DEFELOPI��[ENT <br />2660 Civic Center Drive •:• Roseville, MN 551 13 <br />Phone: (6� 1) 79?-700> s• Fa�: (6> 1) 79?-7070 <br />ADMINISTRATIVE DEVIATION APPLICATION <br />CJTY CODE SEC'I'ION 1013.OJ <br />i��v�v.ci.roseville.mn.us <br />❑ APPLICATION FEE: $75 <br />(Fc�c� s�hoirld be mude pmr�blc� ro Citr of Kosc�i i!!c i�pon sirhmidul nf conrplc�t«f aj�plication.) <br />Please complete the application by typing or printing in ink. Use additiona] paper if necessary. <br />1. Property Owner Information: <br />Last name: ���� f <br />First �tcu�re: L �/L��l!^� <br />Address: .�U�O �i?�lf�y �l/� /� Ciry/State/Zip: ��Pr/�, �� � ;tiI/f% vJ�i/� <br />Pl�orie number: �J% � .�� (�,E /C� Enzc�il address: �c7..S�G�f����''l"�d,�� .C�;�� <br />2. Applicant Information: (if clifferefzt fro�n above) <br />Cornparty nanae: <br />Last raame: <br />Address: <br />Phor�e riumber. <br />First raanze: <br />City/State/Zip: <br />Eniail ad�lress: <br />3. Statement of Intent: Briefly describe the project: why is an Administrative Deviation needed? <br />1 �d���n ��% �> l���•� ,t�q�i��-f �`o /r�i/ l,�r��/���. %�i'.5��%�/�zi/�.� <br />l t ♦ .� i i 1i _ l / ' / .. / � c, i . i . , i <br />��1/f L}^ G� %lr✓o, �Zr�' ,tJi^o; �c:�� �o `'�'C/oco ��� ���r/��.lhid�Y. <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 drawings showing the proposed addition or new Uuilding 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 />§ 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 />Property Ow�rer: ����'c.c�-(���!r� Date: h� ZG��� <br />Applicarit: Date: <br />