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<br />P- -IF 3'd-O! b -1/tloo <br /> <br />- <br /> <br />City of <br />~ <br />Minnesota <br /> <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 Phone: 651-490-2279 Fax: 651-490-2931 <br />E-mail: dennis.welsch@cLroseville.mn.us <br />(City Code, Zoning Map and Comprehensive Plan Map are available on the Internet at: <br />www.cLroseville.mn.us) <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) (."::RerJJ1:.t!.~ ,.., <br />~ee: $25.00- ') <br />p~' <br /> <br />1. COrll1~~ ,41t~H-t!... {P~e'" p~,... 4- --r:&M.6~ Jok",- Poor <br />Name of Owner: (First) (Middle) (Last) <br /> <br />2. /'521 R-oseIQMJ"'- ,4~ Lv 12cseVt({C-, ~ $115- <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />3. <br /> <br />Ph. (,,'5I-~5~-OOq 1 <br />Owner {nformation: (Phone) <br />C!.<<..! ~ bS/. ~o' 5'/66 <br /> <br />-r PaJt... ~ S lilt'!, ( - i?OlH4IV. G(J "" <br />(Fax) (E-Mail) <br /> <br />4. <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />Applicant (if different):(Name) <br /> <br />5. ISZ' f2.osd4.W'" ~ W 14z~ CI', l(~ IIkJ '551 J3 <br />Street Address of Property Involved: <br /> <br />6. (PIN) Property identification number: [!] [i] - ~ It] - I1J Ij] - [1J ~ - IQ] ~ ~ ~ 3 <br /> <br />7. <br /> <br />a. Present Designation of Land: <br />b. Present Use of Property: <br /> <br />c. Zoning of Property: <br />d. Compo Plan of Property: <br /> <br />8. <br /> <br />State specifically what is intended to be done on or with the property which <br />necessitates this Setback Permit: PIt.IA.-$-l! ~~e tA-I/a.dl"- d St..&!.../- <br /> <br />9. <br /> <br />Explain alternatives that have been examined which would enable you to meet existing <br />Code requirements: P'~.e. S~t:. a.lla.ct.~d :5h.e~.J- .. <br /> <br />1 <br />