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~.0. I~o~ 'l~. (567 ~',. <br /> Minne:~l)ohs, MN, 55440 <br /> <br />I~ RIA I~ A. <br /> <br /> CITY OF F~,~SEY <br /> <br />USE PER~:IT APPLICATION <br /> <br />/.--./Board of Adjustment <br /> <br />/7 Conditional Use <br />/ / Planned Unit Development <br /> <br />/___/ Rezoning <br /> <br />/___/ Mining <br /> <br />/___/ Grading or Filling <br /> <br />/__/ Sign <br /> <br />~ Other <br /> <br />J~ame of Applicant: <br /> <br />City/State/Zip Code: <br /> <br />Legal Property Description: <br /> <br />Brief description of the request: <br /> <br />Date reviewed by Board of Adjustment/Pl&~.ning and Zoning: <br />Continents on Reviewal: <br /> <br />Approval/Disapproval: <br /> <br />Reason ~ ~ <br /> ~o~ Disapproval: <br /> <br />Date of Approval: <br /> <br />! ~nderst~_nd the fee for a variance, conditional use pe~it ~nd rezoning if <br />approved or denied, is a non-refL~n~abie fee. i also accept the conditions of <br />this pe-~r, it and all te~s of the .City ordinances which govern. ~ ~nderstand <br />that ~ny ch~aes from these plus must be restarted. <br /> <br /> _~e.. e_ entative Date Zoni~ A~minis trator <br /> <br />Date <br /> <br /> <br />