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<br />-- <br /> <br /> <br />Minnesota <br /> <br /> <br />2660 Civic Center Drive <br />Roseville, Minnesota 55113 Phone: 651-490-2279 Fax: 651-490-293 <br />E-mail: dennis.welsch@ci.roseville.mn.us <br />(City Code, Zoning Map and Comprehensive Plan Map are available on the Intern <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 />1. K e4'<."RY C 1.. J N~ <br />Name of Owner: (First) (Middle) (Last) <br /> <br />2. )73</ s-r41VY.SR'D~ _..A\.J~ I f?nS"i::V)2L..i. t "uN SS=))3 <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />3. ' ~SU636-37~F <br />Owner Information: (Phone) (Fax) (E-Mail) <br /> <br />4. ~1/S..9~~ (./)~ c6S4TR.1\&~.e. ~, ~ Ptvl.... ~s.ns.~) <br />Applicant (if different):(Name) (Address) , (Phone) <br /> <br />5. )754 '5-r/'fN~~1~ Au~ <br />Street Address of Property Involved: <br /> <br />6. (PIN) Property identification number: 0 0 - 0 0 - 0 0 - 0 0 - 0 0 0 0 <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 <br />necessitates this Setback Permit: <br /> <br />~ <br /> <br />9. <br /> <br />Cj' <br /> <br />~~~g~~~ <br />.~~' \ ~ ~)L;)~ <br /> <br />Explain alternatives that have been ex ined which would enable you to meet existing <br />Code requirements: <br /> <br /> <br />1 <br />