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APPLICATION (RECEIPT) NUMBER <br />FEE AMOUNT tC~-.~ <br />ESCROW AMOUNT <br />DATE PAID <br />DATE RECEIVED BY CITY It-~-- ~'~'-~ <br /> <br />CITY OF RAMSEY <br /> <br />LAND USE APPLICATION <br /> <br /> MINOR ~ MINING and <br />~SUBDIVISION RF_.ZONING RECLAMATION <br /> <br />SUBDIVISION <br /> <br />PLANNED UNIT DEVELOPMENT <br /> <br />VARIANCE <br /> <br />GRADING OR FILLING <br /> <br />SITE PLAN <br /> <br />CONDITIONAL USE <br /> <br />Name of Applicant: <br /> <br />Contact Person: ,<~'(LCY'~ t~ <br /> <br /> I <br />City/State/Zip Code: ~'~.((C'O ~'_\/ ~"),/V ,'~"~'~- ~. C'~--'~, <br />Property Identification number: I / - ~ '-~ - : - ,~. t - [ ,¢'r./~/i. - ~. '4. -.~ ~:- ~ -~ '-0', ."~ .~ <br /> <br />Description: <br /> <br />I understand the tee for a variance, condilional use permit and rezoning ~ approved or denied, is a non-refundable <br />fee. 1 also accept the conditions of this perm~ and all terms of the City ordinances which govern. I understand that <br />any changes from these plans must be resubmitted. <br /> <br />Owne r/Representative (printed/~ype d) Date <br /> <br />Owner/Representative(signature) <br /> <br />Date <br /> <br />I hereby certify that I am the fee title owner or contra¢, for deed vendee (circle one)of record for the above <br />mentioned properly. Failure to prove ownership may void any agreement~s~,ter into by the City of,,Ramsey and I <br />be held liable for any and all ccsts incurred by the City. <br /> <br /> (printed/typed) Date er ~s'~ ,u e)"" // Date <br /> <br /> <br />