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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 />tgJ 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. Name of Owner: (First) (Middle) (Last) (Phone) <br /> ((ICHARD "f JOAN PRok:oP G 5- / - Lj g" 1- 0692 <br />2. Address of Owner: (No. And Street) (City ) (State) (Zip) <br /> 700 Co (,.1 /vry Rei 8':1- ~-o/ <br />3. Name of Applicant: (First) (Middle) (Last) (Phone) <br /> <br />4. <br /> <br />St;; c: :# I <br />Address of Applicant: (No. And Street) <br /> <br />~' 13 E- fr '2- <br />5. Street Address of Property Involved: <br /> <br />(City ) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />5613 PI- 2- <br /> <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br />SEE A-1I/f-C/lfi:{) LETTEIC -- G4f(/fGe- ;+tJO/TiOfvl <br /> <br />7. Explain alternatives that have been examined which would enable you to meet existing Code <br />requirements: (' .) <br />5E (i; ArT ACH(;tJ LETTER... /VOlvri <br /> <br />Page 1 of 3 <br />