Agenda - Council - 02/14/2017 - Laserfiche WebLink

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Property Owner Information (If different than Applicant) Name: First Minnesota Bank Street Address: 11431 Jefferson Court N City, State, ZIP: Champlin, MN 55316 Home Phone: N/A Work Phone: 763-488-1568 Email: chuckb@firstmnbank.corn Fax Number: 763-488-3735 • Please provide a detailed description of your request and attached'a copy of a scaled site plan See attached narrative and plans. A. "Land Use Sign" will be placed on the.Subject Property to allow Ramsey Residents the opportunity to obtain information about your request. Applicant Signature �j/tit Co -Applicant Signature Printed Name Troy Halverson Printed Name . Title / . Pre,50,41----- Title Date . /�-/5' 2Q/ Date • . I understand that the application fee Is non-refundable. All costs associated with the processing of this application are the responsibility of the applicant whether this application is approved or denied. Any excess of escrow account deposits over expenditures will be refunded at the time of account closure. I also understand that as the applicant, It is my responsibility to obtain all other permits or licenses required by any applicable regulatory agencies for this Land Use Application. Property Owner Signature Property OwnerC?).241e4D Signature Printed Name First Minnesota Bank Printed Name Charles C. Blair Title Title Executive Vice President Date December '15, 2016 Date I hereby certify that I am -the fee title owner/contract for deed vendee of record for the above -mentioned property. Failure to prove ownership may void any agreements entered into the City and I will be held liable for any and all costs incurred by the City.