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<br /> <br /> <br /> <br />RESIDENTIAL PROPERTY OWNER - $25 <br />(All fees payable upon submittal of completed applicatiou) <br /> <br />Please complete the application by typing or printing in ink. If the <br />additional sheets, keying information to the proper numbers: <br /> <br />provided are insufficient, use <br /> <br />1. <br /> <br />Name of Owner: <br /> <br />(Middle) <br /> <br />(Phone) <br /> <br /> <br />2. <br /> <br />Address of Owner: (No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br />3. <br /> <br />Name of Applicant: (First) <br /> <br /> <br />(Middle) <br /> <br />(Last) <br /> <br />(Phone) <br /> <br /> <br />4. <br /> <br />Address of Applicant: (No. And Street) <br /> <br />(City) <br /> <br />(State) <br /> <br />(Zip) <br /> <br /> <br />5. Street Address of Property Involved: <br /> <br />6. State exactly what is intended to be done on or with the property that requires the setback <br />permit: <br /> <br /> <br />,. would enable you to meet existing Code <br /> <br /> <br /> <br />Page 1 of 3 <br />