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<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 />'g) 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: <br /> <br />-){ <br /> <br />Address of <br /> <br />) q31 ChV\YCh, \ \ <br /> <br />Name of Applicant: (First) <br /> <br />(Middle) <br /> <br />C ~ <br />(No. And Street) <br /> <br />(Phone) <br /> <br />(First) <br /> <br />D (Last) <br />,he ' u <br />(City) (Sta <br />s:/; IV. J ~ DJ e II 11 \ ~ <br /> <br />, <br />(Middle) (Last) <br /> <br /> <br />7Gb .- D760 <br /> <br />2. <br /> <br /> <br /> <br />fv1 N S(;;/ / J .< 33/7 <br />(Phone) , <br /> <br />3. <br /> <br /> <br />4. <br /> <br />Address of Applicant: (No. And Street) <br /> <br />(Zip) <br /> <br />(City ) <br /> <br />(State) <br /> <br />5. <br /> <br />C\ 1N\e.... <br /> <br />Street Address of Property Involved: <br /> <br />".. .> <br /> <br /> <br />6. <br /> <br />State exactly what is intended to be done on or with the property that requires the setback <br />permit: A L . . b <br />c-M 1.- b,! ~ 0 1"' (,\ 3 e. s-t-" \ \ -k I'l I> rlj" S /0. e, <br />or h 0 I",e) J'''Y'~'e, . V Ci v:: I' c.t id c e 1'\ e eJ ~ tu r <br /> <br />~~;t{b~:;lbo:idcv2~uJ j~r"je.- C'fpi1!X. j-~b (-FhJ~ <br /> <br />1!;xpl~in a7ternatives tliat have been exaryned which would enable you to meet existing Code <br />reqUlrements: D h b l/ <br />. . r !AS' . AI!f-.~r- ~L vJOlAfJ f't r"',' Y'e.- <br />I t :to.] D bttr:k '. /0/ Q V1d cAJ rl~ ld' i{ <br />II t + .be. fro-+ I 0. IV 011 e. ct. ro. I 1 ",/:J Ie.- rfVr <br />~Ui (itr +-. ~YC/hl,+J. <br /> <br />7. <br /> <br />Pagelof3 <br />