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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 />~ 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: (First) (Middle) (Last) (Phone) <br />{( 0 DtfL,f- E I etk.tc j' .faV\ A...- (,57 - <1 (?" 0 C(L ( <br />Address of Owner: (No. And Street) (City) (State) (Zip) <br />19b l( ''1- ':!J ~ 1Jv!S( vJ '7ld Jp U I II ~ t-1/. AI ~""SI ( '5 <br />Name of Applicant: qFirst) (Middle) (Last) (Phone) <br />S-"U J'_JE:( ( C'y(2.p (Dpl1 /I /J ) b 51 r ((; Y--S- O~:;> ( <br />Address of Applicant: (No. And Street) (City) (State) (Zip) <br />Jf-pAJ2 ~ N ~::ll I' </ <br /> <br />6 ~lf ',n;tv\ j ~M 1t Jl <br />Street Address of Property volved: <br /> <br />" <br /> <br />2. <br /> <br />3. <br /> <br />4. <br /> <br />5. <br /> <br />( 810 <.( 72. <br /> <br /> <br />IN .Iz. uJ <br /> <br />'7Z-iJ J-f? Lit I! A- <br /> <br />6. State exactly what is in -ended to be done on or with the property that requires the setback <br />permit: <br /> <br />C6? 1Jh,:J '< t (jYV' <br /> <br />f <br />:5 () ~s~ -f., PC <br /> <br />1lJ <br /> <br />24" <br /> <br />f.e -e.if- <br /> <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: <br /> <br />I,?' f/)-J,j- <br />f-p ,I L?~(, <br /> <br />.jIL~ <br /> <br />d'v> / J jJ~J ~ <br /> <br />~ I I <br />b':!Q J 1"; d <br /> <br /> <br />.:5 u B IKtc <br /> <br />~. <br />(f <br /> <br />Page 1 of3 <br />