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PERJ'tXT FEE <br /> <br />DATE FEE PAID <br /> <br />CZTY OF I~dqSEY <br /> <br />~_/ Board of Adjustment <br /> <br />[ / Conditional Use <br /> <br />/~/ Planned Unit Development <br /> <br /> ame of Applicant: <br /> <br />d~ity/$tate/Zip Code <br /> <br />~/ Rezoning <br /> <br />~_/ Mining <br /> <br />~_/ Grading or FAlling <br /> <br />/Legal Property Description: <br /> <br />rief <br /> <br />Date reviewed by Board of Adjustment/Planning and Zoning: <br /> <br />Comments on Reviewal: <br /> <br />Approval/Disapproval: <br /> <br />Reason for Disapproval: <br /> <br />Date of Approval: <br /> <br />! understand the fee for a variance, conditional use permit and rezoning if <br />approved or denied, is a non-refun~able fee. I also accept the conditions of <br />this permit and all terms of the City ord/nances which govern. I understand <br />that any changes from these plans must be resubmitted. <br /> <br />Owner or Representative Date <br /> <br />Zoning A~inistrator <br /> <br />Date <br /> <br /> <br />