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FEE AMOUNT <br />ES=ROW AMOUNT <br />DATE PA~D <br />DA~ RECEIVED <br /> <br />CrTY OF RAMSEY <br /> <br />LAND USE APPLII;;ATION <br /> <br />MINOR ~, MINING and <br />SUBDIVISION RE.ZONING % RECLAMATION <br /> <br />SUBDIVISION VARIANCE SrTE PLAN <br /> <br />PLANNED UNIT DEVELOPMENT <br /> <br />GRADING OR FILLING <br /> <br />CONDFI'IONAL USE <br /> <br />Property Identificati~ <br />Fee '13t~e Owner,~~ <br />Subdivision Name <br /> <br />Desc~'iption: <br /> <br />I understand the tee tot a variance, m3ndhional use ~erm~ and rezoning if aoDroved or denied, is a nun-refundable <br />fee. J aJ~ a~ep: the ~nd~Jons of this ~rm~ an~ ali ~e~s ~f the Ci~ ordinances which govern, understan~ <br />any ~anges trom these plans taus1 be resubmi~e~. <br /> <br />Owner~epre~en~a~ive(prime~e~) Da~e Owne~Represe m~t~e(sig~a~re) <br /> <br />Date <br /> <br />I hereby certHy thai i am the tee title owner or con:ra~ ~or deed ven(3ee (circle one)ot record tor 1he above <br />mentioned property. Failure tc 13rove ownershi:~ may voicf any a.=reements enter into by l.l~e City of Ramsey anc~ i will <br /> <br />Owner (printec~/~3, ped) z D~a~e Ow~er (s~na~ure) ~ <br /> <br /> <br />