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~ ;.-~ <br />1 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />PAID ~ S~ <br />Rec. No. <br />Comprehensive Plan Amendment ____,L1_ Conditional Use Permit `~ S~ '~ <br />Zoning District Amendment Variance <br />X Text Amendment ~~SU S <br />bdi <br /> u <br />vision <br />Other ~ Planned Unit Development <br /> Plan Review <br />Applicant ~/'an~%n 1!~e~~'~-o r1 o?OS E. Go• -~0. dd 335 6S'~~ 0?6 /-P0o 7 <br />(Name) / ~ /1'f (Address) <br />/-] (Phone) <br />Owner <br />(Name) (Address) <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />~-] 6 O 1, a Ke 5ko re ~ ow~ ~eva~~ L,; t7'l~ Car~,o(~ <br />- 5ko ~ "~O1 CC.w~-G !'_ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />T ~f <br />O d•C/' <br />L <br />~q~"~"O 0 1,~ 5 r h2 SS , <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 furs acknowledge the fee explanation as outlined <br />in ~' application procedures and hereby agree to pay all eme is r Ived fro the City pertaining to additional applica- <br />tio~ ,~pense. , 7 <br />WHITE-Office CANA nY-Customer PINK-File GOLD-Planner <br />)~-- (Date) <br />