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,~_~ CC nC ®® CCppl~ ~+ /~n /'~/~T pptl~ Deposit# ~~)(~~~ <br />E ®~ V GL®rGfl ®GP-®J0~ Pi~l'~~CN I'®Itl <br />City of Little Canada <br />515 Little Canada Road East -Little Canada, MN 551 1 7-1 600 <br />651-766-4029 (Fax 651-766-4048) <br />www.ci.little-canada tun us <br />Applicant's Name f, Address Phone # <br />Owner's Name Address Phone # <br />Tom 33 ~: C~u~v ~ L.. C~-n,~r~ ~~l-~Oq-7'00 <br />Property Location (street address and legal description, if known) <br /> <br /> <br />Description and/or Reason for Request (cite ordinance sections, if known): <br /> <br /> <br /> <br /> <br /> ACTIONR'EQUESTED (check all hat apply).: <br />In signing this application, I hereby acknowledge <br /> <br />that I have read and fully understand the <br />Architectural Review <br />applicable provisions of the Zoning and <br /> <br />Subdivision Ordinances and current <br />Concept Review <br />administrative procedures. I further acknowledge <br /> <br />the fee explanation as outlined in the application <br />Conditional Use Permit <br />procedures and hereby agree to pay all <br /> <br />statements received from the city pertaining to <br />Final Plat <br />additional application expense. <br />Planned Unit Development <br /> <br /> <br />Signature of Applicant, if not Property Own Preliminary Plat <br /> Subdivision <br />Signature of Property Owner <br />Text Amendment <br />~~Q <br />Q~ <br />8 -y -~~ <br /> <br />Date Variance <br /> Zoning District Amendment <br /> Other: <br /> ~ J <br /> Total Deposit $ SC~ <br />