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<br />.' <br /> <br />'~~0 ~) <br /> <br /> <br />. ..22 . 9 <br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE -ROSEVILLE, MINNESOTA 551 U-PHONE: (651) 490-2279-FAX: (651) 490-2931 <br /> <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br />Fee: $25.00 <br /> <br />1. <br /> <br />+i frF{6'J.. D <br />Name of Owner: (First) <br /> <br />fL <br />(Middle) <br /> <br />G(LLlMR~ <br />,Last) <br /> <br />2. )r'=:i1 CCfA.VV)Y' AOA-D B.~ iJ..J. RO~'5..V{L.l..lS /V)y')) ~~";)"~ <br />Address of Owner: (No, And Street) (City) (.'>tate) (Zip) <br /> <br />3. <br /> <br />w-/, ~~/~ Io~d~ <br />Owner Information: (Phone) (Fax) <br /> <br />(E-Mail) <br /> <br />4. <br /> <br />5 A- M Q.... <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 />(PIN) Property identification number: <br /> <br />'2.~ <br /> <br />7. <br /> <br />a. Present Designation of Land: R-=-/- <br />b. Present Use of Property: <br /> <br />c. Zoning of Property: <br />d. Compo Plan of Property: <br /> <br />8. State specifically what is intended to be done on or with the property which <br />necessitates this Setback Permit: R 6.. p;..., I:)c. 15 D R I vaIN f7. y <br /> <br />9. Explain alternatives th <br />Code requirements: <br /> <br /> <br />~CJ\. <br />v\,\ ~/ <br />