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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 />o 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 />(Phone) <br /> <br />Name of Owner: (First) (Middle) (Last) <br /> <br />Joseph PC1+v-~C Ie G I eCt b'tQ,'1 <br />Address of Owner: (No. And Street) (City) (State) <br /> <br />7 !.f '+ 1-1 e,' VI e ( DR, R 0 s e v l 1/ e M VI <br />Name of Applicant: (First) (Middle) (Last) <br /> <br />j c> S e p h pc; + r ( C k G l ea s 0 V\ <br />Address of Applicant: (No. And Street) (City) (State) <br /> <br />'7 '+4 1-1 e i V\ e I D v-. R. 0 $' e V I II e (\1\ vl <br />5. Street Address of Property Involved: <br /> <br />t, 5 1- 7 (, c; - if b4 4 <br />(Zip) <br />55' 1/3 <br />(Phone) <br />to ~ J- ? (, s- 4 b 4 L/ <br />(Zip) <br />5'5113 <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />744 <br /> <br />HeiVlel Or'. <br /> <br />Rosevl lIe (VII'l, 551/3 <br /> <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br />E yt--e ....... cp e'i \ S + I' V1J Jy I \.Ie lZJC\ y .t () tk e 5' tV s/cl e <br />fl' D . 0 L "' I {I <br />() {- \"\ €.. It 04 S'e.. " t"l\ie wo...y W o'~ \ o~ ~ e (,:3 wi vi /::::.,1 <br />.-1\.. e:. VV\ ~ C1 Vti CSe +0 l.v i':l ~ . A ';;l., fee t- (J f p,rD reV" 1-)' 1,' VI e , <br /> <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: N <br />b V\ <'2- <br /> <br />Page 1 of3 <br />