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Litt6e Canada, Minnesota <br />APF'LiC,4T1t7N FARM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />-~ Other <br />Applicant <br />(Name) <br />Owner <br />c '~ a ,~ <br />d lOn~ _ - <br />Rec. No,~ <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />3.19-7~3~~~13 <br />(Address) (Phone) <br />(Name) _--- <br />(Address) <br />Property Location (Street Address and Legal Description): <br />a 3 ~ ~ ~ i Gz S-~ye~'t ~.. i 1-F ~ ~ ~tra~.a. Yh 7~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />w ..w / QL1 r/rt1U1 L)VI~OIn .a n ~ ~~ JG•71,~~ (~~B< <br />~-1-c ~;~~'nq~. V/~~I'nnr~cS, only a~~la..« .~e oZ Sim. ~q <br />ddl~,~,~~ ~I~~, ~tiA(I ~ ~-~~ ~ 7,~,w -- <br />i ~ Sr `.z e o,e <br />(Phone) <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 />tion expense, n <br />~r~ ~ (~~ 0a-Z3-otf <br />WHITE-DHlcc cnNaav_ (Signature of Applicant (pate) <br />Customer PINK-File GOLD-Planner <br />•+3>~C) <br />