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APPLICATION NUMBER <br />FEE AMOUNT ~_~ _~ <br />ESCROW AMOUNT <br />DATE PAID /- ?..~ <br /> <br />CITY OF RAMSEY <br /> <br />LAND USE APPLICATION <br /> <br />MINOR MINING and <br />SUBDiViSION REZONING RECLAMATION <br />SUBDIVISION VARIANCE ~ SITE PLAN <br /> <br />PLANNED UNff DEVELOPMENT <br /> <br />GRADING OR FILLING <br /> <br />CONDITIONAL USE <br /> <br />Property Identification number: <br /> <br /> I understand the fee for a variance, conditional use permit and rezoning if approved or denied, is a non-refundable <br /> fee. I also accept the conditions of this perm~ and all terms of the City ordinances which govern. I understand that <br />: ch,,~es fr.om thes_e pla:~s must be resubmitted. <br /> <br /> O/wner/P/epresentative(printed/ty'ped) Date Owner/Representative(signature) Date <br /> <br /> · / <br />] hereby_certify that Yam the owp.,er of record for the above mentioned property. Failure to prove ownership may void <br />any a~,~'~ze, e~nts ~in .,~y tjX' City of Ramsey and I will be held liable for any and all costs incurred by the City. <br /> <br />OwnelC(pri~t~8/tyPed)' - / Date Owner (signature) Da!.e <br /> <br /> <br />