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pf_03116
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pf_03116
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Last modified
7/17/2007 12:40:08 PM
Creation date
12/8/2004 3:50:35 PM
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<br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE -ROSEVILLE. MINNESOTA 55113-PHONE: (651) 49Q-2279-FAX: (651)490-2931 <br /> <br />PAVEMENT MANAGEMENT PROGRAM <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br /> <br />1. <br /> <br />tv! )//c< hz <br />(Middle) <br /> <br />'J t1Cj1J J:ict I/;~y S'/ M?~xVi ) / (j" <br />Address orOwner: (No. And Street) (Citv) <br />Lff<;-o-c,) I.f<) - <br />t~/J-8C;3 -(7392. (t/) -RS3 -.?(i) 7 ) <br />Owner Information: (Phone) (Fax) <br /> <br />J2;:c} c (' <br /> <br />Name of 0 er: <br /> <br />(First) <br /> <br />/ (0 'A <br />~ rl CI/ <br />(Last:) <br /> <br />2. <br /> <br />/lfrl/ <br />(State) <br /> <br />.>S/)~3 <br />(Zip) <br /> <br />h <br />3.\\). <br /> <br />(E-Mail) <br /> <br />4. <br /> <br />Applicant (ifdHferent}:(Name) <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />5, .~!/ 96' Gi/llc//' <br />Street Address of Property Involved: <br /> <br />6, <br /> <br />a, Present Designation of Land: <br />b. Present Use of Property: <br /> <br />R <br />R <br /> <br />c. Zoning of Property: R-l <br />d. Comp, Plan of Property: LOR <br /> <br />{,~/.uLu <br /> <br />Sl <br /> <br />~ <br /> <br /> <br />APPROVED <br /> <br />NOT APPROVED <br /> <br />B: <br />Title: <br />D,R.C. Review Date: <br /> <br />Date: <br /> <br />B: <br />Ti tl e: <br />D,R,C. Review Date: <br /> <br />Date: <br /> <br />Q:\PlanningCommission\Other Documen,.\PA VEMENT MANAGEMENT PEMHT.doc <br /> <br />Cv~ <br />v\:~/ <br />
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