Agenda - Council - 07/23/2019 - Laserfiche WebLink

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Authentisign ID: A626C414-0F93-4815-9CB9-44DACB7A324D Property Owner Information (If different than Applicant) Name: Michael Glanz Street Address: 9020 173rd Avenue NW City, State, ZIP: Ramsey, MN 55303 Home Phone: Work Phone: Email: Fax Number: Please provide a detailed description of your request and attached a copy of a scaled site plan We are requesting minor plat approval to subdivide two new residential lots from the existing property. This will result in three total residential lots, including the existing homestead on one lot and two new lots for future builds. 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 Co -Applicant Signature Printed NamePt Printed Name Title Title Date — / 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 p Y na Si ture g —Authenns � Michael g ti,� "6/6/20193:31:39PMCDT Property Owner Signature Printed Name Michael Glanz Printed Name Title Title Date 06/06/2019 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.