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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 />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 />/VI;1/' <br />(Last) <br /> <br />(Phone) <br /> <br />to [; I ~ t./?J7- 3 'if1r <br />(Zip) <br /> <br />S-S-} I 3 <br />(Phone) <br /> <br />3. <br /> <br />1"8 (2- Dl9le <br />Name of Applicant: <br /> <br />C-DIA,.!!-t. <br />(First) <br /> <br />(City) <br /> <br />!(o~ u; /Ie <br />(Middle) <br /> <br />(Last) <br /> <br />&'4lv; j// <br />(State) <br /> <br />1. <br /> <br />(First) (Middle) <br /> <br />17m fAu/ <br />Address of Owner: (No. And Street) <br /> <br />Name of Owner: <br /> <br />2. <br /> <br />4. <br /> <br />S4111e !k q~,je <br />Address of Applicant: (No. And Street) <br /> <br />\ \ I ( <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. Street Address of Property Involved: <br /> <br />5 1I-v'l1 ~ #5, /f bjl v .e <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br />A COt./i'/(e;;) deck wll! he A-dchyj f-o -f~ f'; i5111 home, <br /> <br />7~;5 w,' If exl-u-z/ o"1.f Ftt"n1 fbuse !?/ I .-10 ~'of <br /> <br />1> ilofet? ..).1..{ l,"/J e.. ("m l/ elj Ie t1 f.tf f. , 'eVl S J <br />.J v ~ <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br /> <br />71..e 1/ / ft'/2I'l/(fl,'€/{l1 t-vot.dd /!;e 10 &Ii ~..e Dt2cJc "'v)fh ovel <br />;( e7() F; <br /> <br />Page 1 of 3 <br />