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<br /> <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-2931 <br />(City Code is available on the Internet: www.ci.roseville.mn.us). <br /> <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <br /> <br />D RESIDENTIAL PROPERTY OWNER FEE - $25 <br />(All fees payable upon submittal of completed application) <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br /> <br />1. <br /> <br />Name of Owner: (First) (Middle) (Last) <br /> <br />(:if~I-f.q-r.L() J 0 e;-i IV If 0 ~EC,t:- <br />Address of Owner: (No. And Street) (City) (State) <br /> <br />I I 3 3 f~ n SC? l r/:m./fV 4vt: tu f0JSI::7IJLL E Ih/IJ <br />Name of Applicant: (First) (Middle) (Last) <br /> <br />R l C-t+ ,q-,<1<...O cJ rJ t-f~(0 H-ro UCA:::: <br />Address of Applicant: (No. And Street) (City) (State) <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />(Phone) <br /> <br />G!;'-"- +69- fOb 1 <br />(Zip) <br /> <br />S-S { 13 <br />(Phone) <br /> <br />.j' j?tj- ( 0 b r <br />(Zip) <br /> <br />S,A-PVI e: <br />5. Street Address of Property Involved: <br />() !J I <br />f ( d.?- (f 3 i K.o~t::-l..j+W.v hUG U) <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: , <br />Ifvt> lr-f(D f(r PT I~O H-OuSf:: HNO G A-~; F -4Tr;q{:i-l-~, 0 <br /> <br />, <br />f.-t:JT is ;;qSr-=T 'D6e-P BVi ONLY 7.:'5i-=r WIDG, loF SiD/? rOl+-iU-tGE <br /> <br />, <br />S';:,t"';) f:;J~+-c.lC- (tJ D (> L P f.i e~Ce:5S l'rr+T6' t2..t:']VlOc/I'+-L of 1-1-0 U-r.;,7 Wh....' Dou] <br /> <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br />ONLY (JTrfF;C ,<h'Tt:':p/L(,rTU//c:'S fft?F ~ SrfDiC.re-,;:J G3r'r;CI.Af,cd:::-(RJo Stftllc-i- <br /> <br />F'o:2. LI<J/!..rb e <br /> <br /> <br />) I'C'~ /0 <br /> <br />r <br /> <br /> <br />1<t:3/)VCt;:-S T['/I2..N <br /> <br />t7-K..()I.);....iO IN FK'..DI-..( r OF ~:'r'}r'ZA0E flIt/v /LlLP4-C c-"7if7t;'/l.rT <Cf1;:';'- <br /> <br />tOr U VI'') W s: FD 12 <br /> <br />r+O 111 el, <br />I <br /> <br />Page 1 of3 <br />