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<br />1 ^ <br /> <br />City of <br />.SBVfbbE <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@ci.roseville.mn.us <br />(City Code, Zoning Map and Comprehensive Plan Map are available on the Internet at: <br />www.ci.roseville.mn.us) <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) <br /> <br />Permit # 3~1 <br />Fee: $25.00 <br />PF# <br /> <br />1. <br /> <br />~~ <br />(Middle) (Last) <br />I~S-<g HGlV\'\ll~ A-~tJ ~(/l(' (c:-YVttv' S-S-II:S <br />(City) (State) (Zip) <br /> <br />~~\ <br /> <br />Name of Owner: (First) <br /> <br />f/w.cJuv s C/V\- <br /> <br />2. <br /> <br />Address of Owner: <br /> <br />(No. And Street) <br /> <br />3. <br /> <br />651 - \0 \.{ ;}- -9 '1/;>- <br />Owner Information: (Phone) <br /> <br />(E-Mail) <br /> <br />(Fax) <br /> <br />4. <br /> <br />Applicant (if different): (Name) (Address) (Phone) <br /> <br />5. I <b5"3' H-avvd\rv-L A-lK-~O~l((( -e.. 'rnfJ ~I( ~ <br />Street Address of Property Involved: <br /> <br />6. (PIN) Property identification number: <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 prope <br />necessitates this Setback Permit: C(J~S u..d-\'~ <br /> <br />~ r~or <br /> <br /> <br />9. <br /> <br /> <br />~ <br />