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APPLICATION (RECIEPT) NUMBER <br />FEE AMOUNT <br />ESCROW AMOUNT <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 VARIANCE SITE PLAN <br /> <br />PLANNED UNIT DEVELOPMENT <br /> <br />GRADING OR FILLING <br /> <br />CONDITIONAL USE <br /> <br />Property Identification number: <br /> <br />Subdivision Name: <br />Description: ~- I <br /> <br />I understand the fee for a variance, conditional use permit and rezoning ff approved or denied, is a non-refundable <br />lee. I also accept the conditions of this permit and all terms of the City ordinances which govern. I understand that <br />any changes from these plans must be resubmitted. <br /> <br />Owner/Representative(printed/typed) -Owner/Representative(signature) I D~'te <br /> <br />mentioned property. Failure to Prove ownership may void any agreements enterS,, o by the City of Ramsey and I will <br />be held liable for any and all costs incurred by the City. -~'"-~L~'¢~'~-"~ J/ , <br /> <br />Owner (printedAyped) / Date/ (._.~,r~r'(signature) /~Da'(~ <br /> <br /> <br />