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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 /> <br />"'" <br /> <br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTJ\-tENT <br />2660 CIVIC CENTER DRIVE -ROSEVILLE, MINNESOTA 55113-PHONE: (651) 490-2279-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 />l)vJ~~ ot:- <br />Name of Owner: <br /> <br />~ <br /> <br />(First) <br /> <br />(Middle) <br /> <br />Ro~vJIL& <br />(City) <br /> <br />~(und. <br />(LasJ) <br /> <br />2. <br /> <br />2(gg 1 fv\a ti (do.. Sf- <br />Address of Owner : (No. And Street) <br /> <br />. 1-1 t~ <br />(State) <br /> <br />5S'113 <br />(Zip) <br /> <br />3. <br /> <br />0J~I- 4\ 5 .qq3 '-t <br />Owner lnformatjol1: (Phone) <br /> <br />(lea x ) <br /> <br />(E-Mail) <br /> <br />4. <br /> <br />Applicant (if different):(Name) <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />5, 2~61 Mu-~ 1<1:\ 'Sf- RO~t;'JLL <br />Street Address of Property 1 n valved: <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 Pro perL)': B-1 <br />d. Camp, Plan of Property: LDR <br /> <br />S~' . <br /> <br /> <br />Da~ o~~I:ation Submission <br /> <br /> <br />~~}V) <br /> <br /> <br />NOT APPROVED <br /> <br />Date: <br /> <br />Q:\Plllnning Commission\Other Documl"nts\P A VEr-.tE.''T MA~AGE1\tE..'\T PERl\tJT.doC' <br /> <br />~~O\ <br />
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