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<br />! <br /> <br />. <br />... <br /> <br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE .ROSEVILLE, MINNESOTA 55113.PHONE: (651) 490-2279.FAX: (651) 490-293\ <br /> <br />PAVEMENT MANAGEMENT PROGRA1\1 <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br /> <br />1. <br /> <br />Rlt::h-ar J <br /> <br />Name of Owner : <br /> <br />(pjrst) <br /> <br />J6e <br />(Middle) <br /> <br />;-/.e /IA/J <br />(Last) <br /> <br />2, <br /> <br />;2 b' 7 '3 /l1;2 i j'Ld cl ''i205eU/ / Ie. <br />Address of Owner: (No. And Street) (Cit\r) <br /> <br />JJ1N <br />(5/;a te) <br /> <br />-- <br />S.!J 1)3 <br />(Zip) <br /> <br />3. <br /> <br />6~-1 -1'8"3 10/3 <br />Owner Information: (Phone) <br /> <br />(Fax) <br /> <br />(E-lvlail) <br /> <br />4. <br /> <br />Applicant (if different):(Name) <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />5, <br /> <br />Street Address of Property Involved: <br /> <br />6. <br /> <br />a. Present Designation of Land: <br />b. Present Use of Property: <br /> <br />B <br />B <br /> <br />c. Zoning of Property: B-1 <br />d. Compo Plan of Property: LOB <br /> <br />1!i~r~ <br /> <br />-A,oi-( / X- <br />Date of Application Submission <br /> <br />/'199 <br />. <br /> <br />APPROVED <br /> <br />NOT APPROVED <br /> <br />B: <br />Title: <br />D,R.C. Review Date: <br /> <br /> <br />B: <br />Title: <br />D.R.C. Review Date: <br /> <br />Date: <br /> <br />Q:\Planning Commission\Other Documents\PA VEMEST ~,,1ANAGEj\IE:\'T PE~\IIT.do(' <br /> <br />('7 .~ f\, <br />v\o"'t) <br />