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APPLICATION NUMBER ~// <br />FEE AMOUNT /'(") C~ c--~--~ <br />ESCROW <br />DATE PAID <br />DATE RECEIVED BY CITY <br /> <br />CiTY OF RAMSEY <br /> <br />LAND USE APPLICATION <br /> <br />MINOR MINING and <br />SUBDIVISION REZONING RECLAMATION <br /> <br />SUBDIVISION VARI_ANCE SITE PLAN <br /> <br />PLANNED UNIT DEVELOPMENT <br /> <br />GRAD~'NG OR FILLING ~ CONDITIONAL USE <br /> <br />Name of Applicant: ~/J,-~c_ I~,'~(,..~.¢:.~.,,.. ~'.,.,'~ ('~ .,~ <br />Contact Person: <br /> <br />Address: /~'7 <br /> <br />City/State/Zip Code: '/~c~.~,~,. <br /> <br />Property Identification number:. <br /> <br />Phone# ,q~/- c. 5~/c, <br /> <br />Subdivision Name <br /> <br />Description: <br /> <br />I understand the fee for a variance, ~nd~ional use perm~ and rezoning E sppmved or deni~, is a non-refundable <br />fee. I also accept the ~ndAions of this ~rm~ and all te~s of the Ci~ ordinances which govern. I understand that <br />any changes from these plans must be Tesubmi~ed. <br /> <br />Ow~er~pres~n~ative (printedAyped) / Date -- Owner~epresentative(signature) Dale <br /> / / <br /> <br />I hereby cert~y that I am the fee title owner or contract for deed vendee (circle one)of record for the above <br />mentioned property. Failure to prove ownership may void any agreements enter into by the City of Ramsey and I will <br />be held liable for any and ,all costs incurred by the City. <br /> <br />Ovyner (printed/ty'4~ed)' ~v'x }/.,/~'" ~'-'~t~ Owner <br /> ' 7.~ ~j~., <br /> <br /> · _~ ,,~. ~ ,'N. ,"--<----- ~,..,~ ~ -/~ ~.,~,'~_ 'T,','"- <br /> <br />,, .... ~ -W---,..oc,.,,.'-'--"-"--- - I" - I . ,-----/ - ', -- . / ' A 5- _ ' ?~.. 4 ' <br /> <br /> <br />