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APPLICATION NUMBER .~'/// <br />FEE AMOUNT ,/,"')LO C <br />ESCROW AMOUNT" <br />DATE PAID <br />DATE RECEIVED BY CITY <br /> <br />CITY OF RAMSE¥ <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 />GRADi~qG OR FILLING ,~, CONDITIONAL USE <br /> <br />Name of Applicant: <br /> <br />Contact Person: <br /> <br />City/State/Zip Code: <br /> <br />Property Identifica'lion number: <br /> <br />Phone <br /> <br />Fee Title Owner: <br /> <br />Subdivision Name <br /> <br />Description: t~L)Q.,S,,L~ "~'W (.. ~'Wz>¢~_72.?,'~',c¢,. /lV~e-,¢.4¢.:'~. ',,-w-',C-c,._v'.'N-x~ ,~---o_C"~ (14-_ <br /> <br />I understand the fee for a variance, conditional use permit and rezoning if approved or denied, is a non-refundable <br />tee. I also accept the conditions ol this permit and all lerms ct the City ordinances which govern. I understand 1hat <br />any changes from these plans must be resubmitted. <br /> <br />Owh e r/R/~pr'e se n{'aiive (print;d/t ype d) / Date -- Owner/Representative(signature) Date <br /> / / <br /> <br />I hereby certify 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 />Owner (printed/tC'¢gdt <br /> <br />0__~¢ &-c.~ <br /> <br />~ ~ ~ ........ . I -- - ~' _,. ~ t } ' r <br /> <br /> <br />