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<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 />.;jr# <br /> <br />SETBACK PERMIT APPLICATION <br />(CITY CODE SECTION 1013.05) <br /> <br />r!J jV <br />_ __ ~'l> <br />" "0/ <br /> <br />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 />3. <br /> <br /> <br />Name of Owner: (First) (Middle) (Last) (Phone) <br /> <br />~ {YlPCLU, ( Oa.JZ-,"/LS J<./ C; 5/ V8&; - /;t7a. <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br /> <br />DwAss 0 g/l/cR. SO. Kose-v'(/~ (VJiV S's/13 <br />(First) (Mid~ _ -, (La~t) W~hone) ~l1...~\~,~\4l <br /> <br />Thns"r; - /O-/lleve:s;Ie- :51 L/S7-L/Lfc:J <br />. ant: (No. And Street) (City) (Stat (Zip) <br />38/ OWUSSo g/~~ Se7. i<ose-L///le/Y}/usS//3 <br />Street Address of Property Involved: <br />3BI OWo..SS'O 8lvd. Sa KO':;<fUAI!e-/YJv. S~//3 <br />State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br /> <br />1. <br /> <br />2. <br /> <br />4. <br /> <br />5. <br /> <br />6. <br /> <br />-bem 0 d e,-f-a.c.h edl <br />(0 VI r fv- fA.. 0+- i1 e k-J <br /> <br />G-tJ.-ra-7~ <br />G-a.......tL'7 e <br />( <br /> <br />tAJ /f.- t, <br />LN I' -I L-, <br /> <br />, (~J f-) <br />~ .s e-.f 6C~.Lk <br />I I <br />3 Gv~s+. s el- bue ~ <br /> <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br /> <br />G-v-rq. 7 e, d /(YI& VJ -S;' ) 0 YJ S <br />be- 5 IV) tt-Ile_~ , <br /> <br />UJo~/cl 11~ed' +0 <br /> <br />Page 1 of3 <br />