Laserfiche WebLink
Name: <br />Street Address: <br />City, State, ZIP: <br />Home Phone: <br />Email: <br />Property Owner Information <br />(If different than Applicant) <br />A\' D c� Cov vi <br />1440 U\,Yk <br />Av d n-e_c) MN SS 3b4 <br />Work Phone: <br />Co C. Fax Number: <br />Mn..Vt7 <br />Please provide a detailed description of your request and attached a copy of a scaled site plan <br />A -Co ri.v,c-,rY <br />-r,,L1 , t vrY �wc),Z4s (M\n) <br />cp aNn-A S` K..v- (D j\ W L (V 'P -ev Jc) S-i woc-Cl,-e <br />1 � c 7.1 in 5 b-P \ ( L v1 e I op) Skc>{' r" c ye sit-4 - - ct n c l CR kcjv, <br />cl`��e,1t� <br />"7(,,3--323--5(09 3 <br />A "Land Use Sign" will be placed on the Subject Property to allow Ramsey Residents the <br />pofnity to obtain information about your request. <br />Applicant Signature <br />Printed Name <br />Title <br />Date <br />v?, P >[ Supply <br />gus 1 k_s,S a)1 F. op yY19frr <br />& / // <br />I understand that the application fed -is non!refu able. All costs associated with the processing of this application are the <br />responsibility of the applicant whether this application is approved or denied. Any excess of escrow account deposits over <br />expenditures will be refunded at the time of account closure. I also understand that as the applicant, it is my responsibility to obtain <br />all other permits or licenses required b -a >y ppli .Ile regulatory agencies for this Land Use Application. <br />Property Owner <br />Signature <br />Printed Name <br />Title <br />Date <br />I hereby certify that <br />ownership may void <br />J�(Y U) Sornc,,_ <br />Cov) Adynivi\s-Wo,�o� <br />- -i7 <br />I am the fee title owner/contract for deed vendee of record for the above -mentioned property. Failure to prove <br />any agreements entered into the City and I will be held liable for any and all costs incurred by the City. <br />Co -Applicant Signature <br />Printed Name <br />Title <br />Date <br />Property Owner <br />Signature <br />Printed Name <br />Title <br />Date <br />