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<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 />.~ RESIDENTIAL PROPERTY OWNER FEE - $25 <br />(All fees payable upon submittal of completed application) <br /> <br />Please complete the application by typing or printing in ink. If the spaces provided are insufficient, use <br />additional sheets, keying information to the proper item numbers: <br /> <br />Name of Owner: <br /> <br />(Middle) <br /> <br />(Last) (Phone) <br /> <br />rMAlA/))()JEAJ r;s/-v?3.~dJ <br />(State) (Zip) <br /> <br />1. <br /> <br />(First) <br /> <br />/L)E4tJ ~/(II/lRD <br />Address of Owner: (No. And Street) <br /> <br />(City) <br /> <br />I- g 2 5 m /JI(I~JJ ?o~ IA L{~ <br />Name of Applicant: (First) (Middle) <br /> <br />J1?;J <br />(Last) <br /> <br />55//3 <br />(Phone) <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />5f} Ae-- <br />Address of Applicant: (No. And Street) <br /> <br />(City ) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5. Street Address of Property Involved: <br /> <br />s~ <br /> <br />6. <br /> <br />State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br />ell/} N ($. J Nt) <br />/ <br />.1], L-t 73t.tJ Cr1 K, <br /> <br />/ {) I It; -/-//e- s/h <br /> <br />S/ /U9Lt2_ <br />r <br /> <br />C"A/2 <br /> <br />!f71?lcd;/ <br /> <br />13.; <br />/ <br /> <br />I9PV/4/9 <br />/ <br /> <br />0J J . <br />c .7f? <br /> <br />"'/0 /J- <br />FRfJAir ~ <br /> <br />7. <br /> <br />Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br /> <br />Page 1 of3 <br />