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<br />Minnesota <br /> <br />~~@~om~m <br />'N 0 1 Z001 W <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 />Name of Owner: <br /> <br />SETBACK PERMIT APPLICATION <br />(City Code Section 1013.05) Permit # <br />Fee: $25.00 <br />PF# ~"!>,.~ <br /> <br />/)oer--/'Ier <br />(Last) <br /> <br />t:,rev <br />(First) <br /> <br />E~Ul41'~ <br />(Middle) <br /> <br />1. <br /> <br />2. <br /> <br />;)9'13 G(),//./".- ,sf &s~v///c::. <br />Address of Owner: (No. And Street) (City) <br /> <br />(65;) 787-CJCJY'o <br />Owner InformatioIJ: (Phone) <br /> <br />11/)1 <br />(State) <br /> <br />55//~ <br />(Zip) <br /> <br />3. <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. ;)943 6n1/-''if Sf <br /> <br />Street Address of Property Involved: <br /> <br />6. (PIN) Property identification number: ~ [] - ~ ~ - ~ ~ - II] ~ - ~ ~ IT] ~ <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 Setback permit:Exknd / {!Ar J.o Ol .2d;-- 9 c..('~ IC <br /> <br />9. <br /> <br />Explain alternatives that h~ been e;caq;lined wh~ch would enable you to meet existing <br />Coderequirements:07 G'a.r at!-t(}te.jl~oI jar&1J~ in P<< ,tAG <br />c6tiC,{ VPt'/, t:t;'JpI J?1ti.1C- /AL 5;'/e IIdrd 1#10 <br />Pi t:1h1' ~" a;' ; <br />/ <br /> <br />1 <br />