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~`.' .._1052 <br />Little Canada, .Minnesota PAID ~S~ <br />APPLICATION FORM~~// Rec. No. <br />Comprehensive Plan Amendment -_,Q__ Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant ~usan ~ Car' I <br />C (Name) <br />Owner cJame- <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />7(P~. ~al~re- ~d lPSI -x}83 - ~f5~1/ <br />(Address) <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />(Phone) <br />~1~~ Gore, I~d, <br />Description and/or Reason for Request (Cite Ordinance Sectionsl: <br />e~? <br />;~ i 11 e.dordtl~a,~-e ~- a-~pearan~ of tlu~ 9ara~~- w i~, +~&,e house_ a~ncl alfacl,~4 ~ar~e~ -tf~e <br />r ~ r e u~ilL exceed IS o <br />is nCarly ZQG'-i°s, so 9 ra.9~ wily not o~~y rnor than 250 0~ -yf~ Grcu. <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />it application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tiol~ expense. ~/ <br />(Signature of Applicant) (Date) <br />WHITE-Office CANAHV-Customer PINK-File GO LD~-Planner ..y ~,(~ <br />