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Please provide a detailed description of your request <br />and attach a copy of your property layout (if applicable) <br />F/NAL ice" -A- PA" SEvENT/-...SEVEN (71) /Pow Tew/fs✓NE <br />uw/r <br />LorS <br />A "Land Use Sign" will be placed on the Su• a perty to alloamsey Residents the <br />opportunity to obtain ui o a n about yo� st. <br />I understand that the application fee is now refundable. All co .fated with the processing of this <br />application are the responsibility of the applicant whether this app icatton is approved or denied. Any excess of <br />escrow account deposits over ex en4itures will be refunded at the time of account closure. I also understand <br />that as the applicant, it is my r sinsibility to obtain all other permits or licenses required by any applicable <br />regulatory agencies for this Land Use Application.141 <br />.� <br />ci.va g <br />Applicant Signature <br />Co -Applicant Signature <br />Date <br />I hereby certify that I am the fee title owner/ tract for deed vendee of record for the above -mentioned <br />property. Failure to prove ownership may voi any agreements entered into by the City of Ramsey and I will be <br />held liable for any and all costs incurred by the City. <br />A-s itI3oVE- <br />Property Owner Signature <br />Date <br />Co -Property Owner Signature Date <br />To be filled out by the City of Ramsey: <br />Application amount: <br />Escrow Amount: <br />Date Paid: <br />Cash Receipt <br />Date Received: <br />Escrow Number: <br />2 of 2 <br />Updated: January 2004 <br />