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<br />GRYPHICS It~C <br /> <br />PAGE U:L <br /> <br />11/66/2083 81:09 .1635090077 <br /> <br /> <br />COMMUNITY DEVELOPMENT DEPARTMENT <br /> <br />2660 CIVIC CENTER DRIVE <br />ROSEVILLE, MINNESOTA 55113 <br />PHONE: (651) 490-2279 FAX: (651) 490-:!931 <br />(City Code is available on the Internet: www.ci.roseviIle.mn.us). <br /> <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTlON 1013.05) <br /> <br />o RESIDENTIAL PROPERTY OWNER FEE ~ $25 <br />(AU fees pay~'ble upon submittal of completed BppHclltion) <br /> <br />. <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying informa.tion to the proper item numbers: <br /> <br />1. <br /> <br />Name of Owner: (First) (Middle) (Last) (Phone) <br />3J::ts f/aA/e J O-co9S 0'1 (P/d- L/J?-JiPCCJ <br />Address of OWJ1(!r: O. And Street) (CiTy) (Stale) (Zip) <br />J~f.o SCU7#;u/:sf lJr/ve tJ. ~5e(/i(rJ; J HN s;-~!/_~ <br />Nome of Applicant: (First) (Middle) (Las!) , (Phone) <br /> <br />? HeLl' ;& (j Q (-C),hs(!YJ (tJ j;;)-Lj/t' 3(pCYJ <br />Address oj . !icont: (No. And Street) (City) (Slate) (Zip) <br /> <br />~~3 ~ (fl '-~LoI (~rst Ix-; ve_tU. ~ ~ (j I! (p I L'-iJ1 SS7 J 3 <br />Streel Address of Property Involved: <br /> <br />~_ &(0 :;){J.ndhUJ:I.f- Dr/ve U) T:J~//U)HiVSS-/!5 <br />State exactly 11,1hat is intended to be done on or with the property that requires the setback <br />penn it: ':7. . vi c2 <br />~l)UII tL_... ta/ ,J0/Q-(/5L-. <br /> <br />2. <br /> <br />3. <br /> <br /> <br />4. <br /> <br />5. <br /> <br />6. <br /> <br />7. <br /> <br />Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: . J <br />il ,<; mo/0---6 tJ../iJ,j-9-: h 4S. ~.u7 exam. //I.e r; <br />hL-d -b-d/I/.f,) t71d l7()f Jo be. an aclt2~~ si& <br />~ (o.-r~"J. <br /> <br />p,\:-;c 1 of:1 <br />