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', '~ <br />I~~ 1060 <br />Little Canada, Minnesota PAID ~~s _ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant 1 ' I I {1~ ~f >~~ 1~ ~ ~ nyC t/Y1\/ <br />(Name) ~ J <br />Owner ~~'~ Nl ~° ~l 5 ~,~ OU~'. <br />(Name) <br />Property Location (Street Address and Legal Description): <br />~" Ckr~ <br />~.~r7 <br />(Phone) <br />(Phone) <br />~$~~Z9,zz.~lZ.f~y <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />.n <br />2 <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) <br />(Address) <br /> <br />~On ~d~"Z3 ~~~~- <J <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 the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ti xpense. <br />( ignat re f Applicant) ~ (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Plan~~~~~~__ j ~_io <br />