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1 <br />I <br />Name: • . . <br />i t + <br />Street Adress: , ��.• <br />City, SON, <br />ZIP: +•� <br />Horhe Phone: <br />r <br />Frail: <br />• , , <br />Property Owner Information <br />(If different than Applicant) <br />• Steven Calabrese <br />UZ61 NoL3l-1,en ed <br />Rcfr MN, E53c3 <br />76 3L/?%k, <br />54-eve4-trAxweirvtg lir coriA <br />Work Phone: <br />Fax Number: <br />� ic33 36 <br />• <br />Please provide a detailed description of your request and attached a copy of a scaled site plan <br />:Nike 4-e) pocf- �X <br />pit.Q;(14. <br />c �(� a S i qrL L� af'9{' i� f'►� �% 6 US ��I�eSS i'1Cch'��QYir� " vL�wt ���, Vl ��- 'o r ova r og' t,ock� +ite_ <br />„r M-k4d. ;i3 � Sc�f,ec� s1� ,01av� 5�0�lnQ �-�� S111/1 �1(J1 b�.,I�l�X1' ��o �-�� �e�' 1 %ne �s��: ��ow� -l-�� C'ev�� Ili' ' ��-i-�►e road <br />j <br />ot <br />• ,artiosef - �► e road <br />e <br />A "Land U elsSig n"will be laced on the Pro <br />perty � p Subjectovert y to allow Ramsey Residents the <br />* , opportunity to obtain information about your request. <br />Applicant Signature <br />Printed Name <br />Title <br />S�-erer Ctre <br />Lorte,r <br />Co -Applicant Signature <br />Printed Name <br />Title <br />r <br />Date's Date <br />1 undtrstarid that tapplication fee is non --refundable. All costs associated with the processing of this application are the <br />respor�sibHlity of,the he applicant,hether this application is approved or denied. Any excess of escrow account deposits over <br />expenditures Vi1V'bp refunde1 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 by any applicable regulatory agencies for this Land Use Application. With notice from the City,I <br />understand the Cityy ma need to accesspp • y the property for purposes related to the application. <br />PropErty owneZt; <br />Signature <br />Printed Name <br />Title' <br />.i• <br />Property Owner <br />��'�/eSignature <br />1-eve(t eleetrelsePrinted Name <br />.1' tiL.)/tes,r-- <br />i <br />Title <br />Date Date <br />ti <br />1 hereby certif Vh 1 ani the fee title owner/contract for deed vendee of record for the above -mentioned property. Failure to prove <br />ownership 'v�bld . anyagreements entered into the City and I will be held liable for any and all costs incurred by the City. <br />