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<br />\ <br /> <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) Permit # <br />Fee: $25.00 <br />PF# 32.1:.6 <br /> <br />1. <br /> <br />, --=Ki a~ <br />Name of Owner: (Firs <br /> <br />/1 JLLr ren <br />(Middle) <br /> <br />ljre.e.n <br />(Last) <br /> <br />2. <br /> <br />Ll04 erooKs f\ve~ \tV -:t\OS€J) \ He{ <br />Address of Owner: (No. And Street) (City) <br /> <br />5:) U3.....- <br />(Zip) <br /> <br />mn <br />(State) <br /> <br />3. <br /> <br />jQ5J-lJ3~ --qaQO <br />Owner Information: (Phone) <br /> <br />(Fax) <br /> <br />(E-Mail) <br /> <br />4. <br /> <br />Applicant (ifdifferent):(Name) <br /> <br />(Address) <br /> <br />(Phone) <br /> <br />5. <br /> <br />~O()~f\\)e.- VJ <br />Street Address of Property Involved: <br /> <br />'=R{J~J) ~ \Ie~ m Y\ .5&)112) <br />, <br /> <br />6. (PIN) Property identification number: IT] e1 - ~ BI - ~ 13 - ~ ~ - IQ [g [jJ ~ <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 do~e on or with the property which <br />necessitates this Setbac~ Permit~ltJ(j f)' ffl'" t.\. ,~ fJ (illY <br />-8(1 rt1 r) it) -ex i&-i ~ ~i rllCU-llre ) . <br /> <br />9. <br /> <br />Explain alternatives that have been examined which would enable you to meet existing <br />Code requirements: <br /> <br />1 <br />