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<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) Permit # <br />Fee: $25.00 <br />PF# 32.1:>>6 <br /> <br />1. <br /> <br />'~ic..k~ <br />Name of Owner: (Firs <br /> <br />/1 )l1.r fen <br />(Middle) <br /> <br />~ree..n <br />(Last) <br /> <br />2. <br /> <br />l404 6roo Ks 1\ 'Ie ~ W -:t\05€.D \ H ei, m V\ <br />Address of Owner: (No. And Street) (City) (State) <br /> <br />5::\U3_ <br />(Zip) <br /> <br />3. <br /> <br />jQ5J-lJ8~ --qaq() <br />Owner Information: (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. <br /> <br />~O()~\Je., VJ <br />Street Address of Property Involved: <br /> <br />'=R{k~n \ \ I ~. m Y\ .5&:) U \.":) <br /> <br />6. (PIN) Property identification number: [] gJ - I BI - Iai f3I - ~ ~ - IQ [g [] ~ <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. State specifically what is intended to be done on or with the property which <br />necessitates this Setbac~ ~ermit~i+/(j () ( l'Yf' ~ . '~ eJ MY <br />-8(H"tlr) it) -ex j~::J . ~i n lQj-ure J. . <br /> <br />9. Explain alternatives that have been.examined which would enable you to meet existing <br />Code requirements: <br /> <br />1 <br />