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` <br /> Property Owner Information . <br /> (if different than Applicant) <br /> Name: MQ Ll�q Iry) W1 <br /> Street Address: <br /> City, State,ZIP: j"I N <br /> Home Phone: Work Phone: <br /> Email: Fax Number: <br /> Please providedetailed descr of your request and attached a copy of a scaled site plan <br /> Pt <br /> VVI 0 z* kc:J, X <br /> A °"Lanm/ Use Sign" will be placed on the Subject Property to allow Ramsey Residentsmhe <br /> opportunity to obtain information0bout your request, <br /> Applicant Signature Co-Applicant Signature <br /> Printed Name Printed Name <br /> Title Title <br /> Date Date <br /> I understand that the application fee is non-refundable. 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. |also understand that as the applicant,it is my responsibility to obtain <br /> all other permits or licenses required by any applicable regulatory agencies for this Land Use Application. <br /> Property Owner Property Owner <br /> Signature Signature <br /> Printed Name J''YA! fo 4 Of#clvlo Printed Name <br /> Title Title <br /> Date Date <br /> | hereby certify that|am the fee title owner/contract for deed vendee of record for the above-mentioned property. Failure to prove <br /> ownership may void any agreements entered into the city and |will be held liable for any and all costs incurred by the City. <br />