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~,a ._..1047 <br />Little Canada, Minnesota PAID`~.-~G <br />APPLICATION FORM Rec. --N o. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~~j jG~~, <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Planned Unit Development <br />Plan Review <br />Applicant ~Ll~S C'La - In; U Jy~i <br />- Variance <br />--~_ Subdivision~~C~/ <br />(Address) <br />(Phone) <br />Owner Z3`~6 /~~l~~,Sf /U,5}-(lCtuX. I'~N 651-7br'-2vbc, <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />{ ~ri~v-tom <br />S. <br />Ti, <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />L .. <br />S U 1J ~i !r ZL`V~iVL~C ~1 S <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />inc i Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in tl~a application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />J <br />(Signatur of Ap licant) ~Ir!(~tval_w (Date) <br />WHITE-Office CANARY-Customer PINK-File GO LU-Planner .,a~s,.n <br />