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~~ <br />Little Canada, Minnesota PAID~~~_ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment _~ Conditional Use Permit~SG'C~ <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />(Name) <br />Owner <br />(Name) <br /> <br />sti s:: ~- <br />(Phone) <br />(Hddress) <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />Description and/or Reason for/R~equ'est (Cite Ordgi~n)ance Secti/o7ns): <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 />in t! Dplication procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion ~„pense. <br />/~ /~ p <br />(Signature of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner <br />^6~ <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review /~ , <br />5_-' c <br />(Address) <br />