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Little Canad , IVlinnes®ta <br />APPLICATION FORM <br />PAID .~Z~SC-? <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment ~ Subdivision p~Gt-~' ~ 7~0 <br />Other ~~ _~ Planned Unit Development`~~~~ <br />cJ Plan Review <br />Applicant~~~Un~ V1.eS ~ItiC. ~~'S"(~-((-2,51. 5~1~2.0°I (QJ`1'~Od~-O~I~e7 <br />(Name) (Address)'~,oS?rl~~, ~1i3 (Phone) <br />Owner ~`~~ 0.'S ctrJpUC~ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />I..o~" l , ~locl~ I , ~cw ~t PlacR- 3`a ~dc~.t.`(1~k, '~~ti`x C°~~ic~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that I have <br />ing and Subdivision Ordinances and current administrative <br />' ~ the application procedures and hereby agree to pay all <br />n expense. <br />WHITE--Office CANARY-Customer PINK-File GOLD-Plar <br />and fully understand the applicable provisions of the Zon- <br />u s. I furth r acknowledge the fee explanation as outlined <br />ifts ceiv fr t it rtai to additional applica- <br />,v / V <br />pplicant).~~~ju~~r~~{ry-~ (Date) <br />~ ~ f ~ 4l "'~ ~o <br />