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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 y 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 />I understand the fee for a variance, conditional use permi~ and rezoning if approved or denied, is a non-refundable <br />fee. I also accept the conditions of this permit and all terms of the CH ordinances which govern. I understand that <br />any changes from these plans must be resubmitted. <br /> <br />Owner/Representative(printed/typed) Date Owner/Representative(signature) D~e <br /> <br />I hereby certify that I am the tee title ~)wner or contract for deed vendee (circle one)of record for the above <br />bm: ~tei I°dnl ie~ab IP; 1 Po~ artYn'y Faa~l; rael It LPs tros Vienc°u~ rneedr Sbh~ Pt hme acY it;o, id any agr~r in to b y/th~/~ity of Rams ? ?~l w) ll <br />Owner Iprintedt~ed) Date Owner Isi~nat~re) Date <br /> <br /> <br />