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<br /> <br />33~'L <br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE -ROSEVILLE, MINNESOTA 55113-PHONE: (651) 490-2279-PAX: (651) 490-2931 <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # 7q9 -OO..:::L <br />Fee: $25.00 <br /> <br />1. <br /> <br />vv\ ~c~A~L <br />Name of Owner: (First) <br /> <br />L Mo<:.c..IA <br />(Middle) (Last) <br /> <br />g + ~ RoS~v \ l..L L (VI/'J, SSl l3 <br />(City) (State) (Zip) <br /> <br />2. <br /> <br />t~bq SUmM~~ <br />Address of Owner: (No. And Street) <br />lbS'l) YBq- 9145" <br />Owner Information: (Phone) <br /> <br />(Fax) <br /> <br />(E-Mail) <br /> <br />3. <br /> <br />4. <br /> <br />Applicant (if different):(Name) <br /> <br />(Address) (Phone) <br />~t~ fYJfv~ D~t J 3 <br /> <br />" <br />::I. <br /> <br />J 1 bo, SUi~1nU( -st~ <br /> <br />Street Address of Property Involved: <br /> <br />6. <br /> <br />Complete Legal Description of Property Involved: <br />J 3 / I 'S -Irz (J,j)J c..,'s ADO I i I O'-J <br />f <br /> <br />7. <br /> <br />a. Present Designation of Land: <br />b. Present Use of Property: <br /> <br />c. Zoning of Property: <br />d. Compo Plan of Property: <br /> <br />8. <br /> <br />State specifically what is intended to be done on or with the property which <br />necessitates this Setback PermitJ~ ~IL ~ Roo tv\. A bt) 1't I ON T <5 <br />~~~rrttJ~ 6A~A(;,[, L-IN~ - (l.JN~ IS '-f .f~f -tnon, <br /> <br />P no ff,fZ.. 1"'1 u,., /L.. <br /> <br />twFhT <br />1: J (J-I{.. <br /> <br />9. Explain alternatives that have been examined which would enable you to meet existing <br />Code requirements: Sf...E.. A tTAt'..bR,J) <br /> <br />1 <br />