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/--- Partnership/Corporate Section (continued): Principal Partners/Designated Officials Name: Title: Address: City: State: Zip: Home Telephone Number Employer (if different from above): Work Telephone Number: Name' Title: Address: City: State: Zip: Home Telephone Number Employer (if different from above): Work Telephone Number: Name: ~ 1J1-t-f'L-}.<... Title: '0 \,U N.f Address: (2 o&, tJ/2" 13....'" b..". LOlL f3/v'( City:J+J..il!\, LvII<.- State:jAN . Zip: ':I;30'-/ Home Telephone Number: (16"3) ,<>)- ~~8'1 Employer (if different from above): W or1( Telephone Number: Name: Title: Address: . City: State: Zip: Home Telephone Number Employer (if different from above): Work Telephone Number: A "Land Use Sign" will be place on the Subject Property to allow Ramsey Residents the opportunity to obtain information about your request. I understand that the application fee is non-refundable. All costs associated with the processing ofthis 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 applicabI r ulatory gencies for this Land Use Application. ~I I hereby certifY that 1 am the fee title owner or contract for deed vendee ( circle one) of record for the above .mentioned property. Failure to prove ownership may void any agreements entered into by the City of Ramsey and I will be held liable for any and all cost incurred by the City. j"'c)h" ~. 9t-.}usG N fh;~ l~ \ Owner/Respresentative (print/typed) Date '1' f1ef( f-> E 3 t fJ;,~{frR{) .~ At () ~ ~, Pzktfm L-f) Owner (printed typed) ~.-Co .-0 { Date