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<br />, <br /> <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.ci.roseville.mn.us) <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br />Fee: $25.00 <br />PF# <br /> <br />(]#() /:j; e <br />P;f7Ykf" L-& <br />(First) <br /> <br />~J.c-x,w(J,-,ct- <br />J611;V <br />(Middle) <br /> <br />fJ 4-1 (:j ~:;- <br />!b"V&LL - fY4/Ge <br />(Last) <br /> <br />1. <br /> <br />Name of Owner: <br /> <br />2. <br /> <br />g ~ 0() '"""J?14-;U 2i(jN - S/: ~~ P/~ ?1tAJ <br />Address of Owner: (No. And Street) (City) (State) <br /> <br />SJI/} <br />(Zip) <br /> <br />3. <br /> <br />'S-I c,J(,-j ~~3 <br />Owner Informatioll: (Phone) <br /> <br />(Fax) <br /> <br />(E-Mail) <br /> <br />4. <br /> <br />Applicant (if different):(Name) <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />5. '3cv'o m"NsO~ st. ~6Se..\H LL~ : f'(\ \oJ. ~H3 <br />Street Address of Property Involved: <br /> <br />6. (PIN) Property identification number: D D - D D - D [! - D D - D D D D <br /> <br />7. <br /> <br />a. Present Designation of Land: <br />b. Present Use of Property: <br /> <br />c. Zoning ()f Property: <br />d. Compo Plan of Property: <br /> <br />8. State specifically what is intended to be done on or with the prQperty which <br />necessitates this Setback Permit: 1'1;( j. '/ 611/ A,t;C h~k' 11/LJAJ <br /> <br />9. Explain alternatives that have been examined which would enable you to meet existing <br />Code requirements: <br /> <br />1 <br />