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<br /> <br />'J- <br /> <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' <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 />,q7,~ He/Nt? ( j) r< <br /> <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 />(First) (Middle) <br /> <br />/3rRt.;+ b~er&7 <br />Address of Owner: (No. And Street) (City) <br /> <br />((;t)eV/1 je <br />(Middle) <br /> <br />(Last) <br />,JordahL <br />(State) <br /> <br />Name of Owner: <br /> <br />2. <br /> <br />3. <br /> <br />57011. /fe/Ale I Dt c <br />Name of Applicant: (First) <br /> <br />;VI xl <br />(Last) <br />c70rdCthL <br />(State) <br /> <br />4. <br /> <br />B '~^l {.- &arVj <br />Address of Applicant: (No. And Street) '(City) <br />!~. '/1 <br />kOSt?&!i . e <br /> <br />/v1 A) <br /> <br />5. <br /> <br />5!0 J Hf?/>>e ( Vr, <br /> <br />Street Address of Property Involved: <br /> <br />6. <br /> <br />/},t(C:rJi Ac=>d- ct(l(~ h ;1/ 7b eX /s kJvj <br />In Cl cld t( It) /% ,:j-;:;{ i CfOYQ c;'e. <br />. I I <br /> <br />(Phone) <br />btil-2f"69 -7DIV <br />(Zip) <br />~C;-9 /3 <br />(Phone) <br />& r: / -Lf~ L{ ~70 <br />(Zip) <br />~"i 6/l3 <br /> <br />7 crrC/19 <2- <br /> <br />Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br />,:;e e ,,4 f/zit iJej <br /> <br />7. <br /> <br />Page 1 of 3 <br /> <br />~--;;;:;:.,,?'. <br /> <br />v- <br />