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pf_03138
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7/17/2007 12:43:35 PM
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12/8/2004 3:53:16 PM
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<br /> <br />Minnesota <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br />2660 CIVIC CENTER DRIVE -ROSEVILLE, MINNESOTA 55113-PHONE: (651) 490-2279-FAX: (651) 490-2931 <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br />Fee: $25.00 <br /> <br />1. <br /> <br />J<A-TffrzyfJ <br />Name of Owner: (Flrst) (Middle) <br /> <br />~4z, 7 tJBST~ Ave' J <br />Address of Owner: (No. And Street) (City) <br /> <br />/A-BA-,A <br />(Last) <br /> <br />2. <br /> <br />~sevt'f/GG ,~ Mlt3 <br />(State) (Zip) <br /> <br />3. <br /> <br />h_C)/ ~ L-fg/-/&30 <br />Owner Information: (Phone) <br /> <br />1012- -533'-72jJ~ <br />(Fax) (E-Mail) <br /> <br />4. <br /> <br />5~C- <br />Applicant (if different):(Name) (Address) (Phone) <br /> <br />24{.; 7 WMTt:ruJ Avt:> J /2vSevILL6 ~ ~/'3 <br />Street Address of Property Involved: "" " . <br />C61t/r~Ii!.,lv' /t:Y>J}:la:~J.. ;er!.1.5~/'''' &;J. ,<C,hbei1:? K Ie {Pp>o.ftJ;lAtI!- (/.f\.;/P'"7t 27,2 '6'-/7A... <br />(PIN) Property identification number: IT] [I] - ~ [1] - [bI ~ - ~ [1J @] @] 3 7 / <br /> <br />5. <br /> <br />6. <br /> <br />7. <br /> <br />a. Present Designation of Land: <br />b. Present Use of Property: <br /> <br />c. Zoning of Property: 12.t7 s, HSTD. <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: (1511 sf" LA.Lf,' ~ o'f fA.. ja.r4.j e..., <br /> <br />9. Explain alternatives that have been examined which would enable you to meet existing <br />Code requirements: <br /> <br />c;:~ ~\~ \ <br /> <br />
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