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__ __ _ _________ __ ____ __ _ _ _ ___ /o sy <br />~xj <br />Little Canada, Minnesota PAID ~T~~% <br />APPLICAT90N FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />P(Gwn~„ Planned Unit Development <br />~- Other 5', y vv (e U) ew ~a ~ f <br />~o`""""^'SSi~` Plan Review <br />IJu~ as~o {~~~e SF~ce~ (ds~~as'S-ly~ts <br />Applicant (~~~ (Phone) <br />(Name) (Address) <br />Cus ay cwt 6or E~gewc,}off Ro~r~ <br />Ec9 ewa Jf ` Ccrr ~C xkx (~:tc sfiV~e~t <br />Owner ~ e r ~owk r Gc (Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />xxx I'Si ce s {.tre <br />L~,t- !S. ~31oetX' ( Erb <br />~~st- s~r9e v~ __ R.~ <br />-er ~~WNd~~~ (~aJ'(. CCc~.n.<~y[ ~o+ <br />6~fwe>°~ ~~~~ ~- c.R . <br />Description and/or Reason for Request (Cite Ordinance Sections) <br />q In r~ U `• P c¢ -Fc>-v' n- e <br />`JCr(' ~ <br /> <br />e~br~/ g' <br />[ <br />51 <• C <br />-F-1~~ ~ ~ q ~ w~ ~- e <br />/a.~ <br />S i ~ c9 ~ n..et~ ~ v~-f S I,c Dvf t~ <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />3 and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outliln ac <br />In the application procedures and hereby agree to pay all statements received from the City pertaining to additional app <br />tion expense. <br />Q-- ~ ~/ ~sl ~s <br />~) w-~ h9w~'~---;i~~ <br />(Signature of Applic 1 (Date) <br />,a~~~a, <br />wHITe--Office ::ANAf7Y--Cus[o mer ?INK-rile GOLD-Planner <br />