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APPLICATION (RECEIPT) NUMBER <br />FEE AMOUNT <br />ESCROW AMOUNT <br />DATE PAID ,'~ -- <br />DATE RECEIVED BY CITY 2_ . z t - ~'~ <br /> <br />CITY OF RAMSEY <br /> <br />LAND USE APPLICATION <br /> <br />MINOR MINING and <br />SUBDIVISION REZONING RECLAMATION <br /> <br />SUBDIVISION VARIANCE ..-"~' SITE PLAN <br /> <br />PLANNED UNIT DEVELOPMENT <br /> <br />GRADING OR FILLING <br /> <br />CONDITIONAL USE <br /> <br />Name of Applicant: ~tJ S'T'D~q C..,<~ C ~,q ~/ Phone <br /> / <br /> <br /> 4 -- <br /> <br />Property Identification number: ._._~, ?_J~-,~.~._'L.~ ~ ! ~ ,~'~::;i~ ! <br /> <br />Subdivision Name: <br /> <br /> I understaneF~e fee for a variance, conditional use permit, and rezoning ~ approved or denied, is a non-relundable <br /> fee. t also/accept the conditbns of this permit and all terms of the City ordinances which govern. I understand that <br /> any ch,a.~ge~s;from thes.e.~s mu~st be resubmitted. <br /> <br />/~¢¢~/n ~ r~1=~epr~e nt afire (priate% D'-ate ! O"-~n e r"~Repres e nt'-----"~t,ve (s,~'g n at u re-'~"--'~' D'~'--'--~,-~ <br /> /, <br /> I hereby certify/J,h/at I am the fee title owner or contract for deed vendee (circle one)cf record for the above <br /> mentioned preperty.~ailure to prove ownership may void any agreements enter into by the City of Ramsey and I wi11 <br /> bf:~eld li..~e for ~'an~iall .c~..s in.c~./.~d by the City. <br /> <br />I? <br /> <br /> <br />