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06/07/2004 13:40 6517664048 CITY LITTLE CANADA <br />Little Canada, Minnesota <br />~F'F'LIC~Ti~I~ F~,~M <br />Comprehensive Pian Amendment <br />- Zoniny District Amendment <br />Text Amendment <br />Other cUl'K/~l.~i~Lli/r/J'~! ~/urn. <br />Appi <br />Owner <br />the aa~ fl~v <br />(Address) <br />1.~~~ <br />(Address} <br />Description and/or Reason for Request (Cite Ordinance Sections}: <br /> <br />/D/ g <br />PAGE 02 <br />~~ <br />PAID SG~ <br />Rec. No. <br />/5 (Phone! <br />{Phone) <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the 2on- <br />ng and Subdivision Ordinances and current administr ive procedures. I further acknowledge the fee explanation as outlined <br />n the application procedures and hereby agree to pay all statemen race ed from the City pertaining to additional applisa• <br />ion expense, <br />~ ti3 0~ <br />~HITF,.-Of9ro CANARY-Cor(omar nNi<_ ignature of Applicant) (D tel <br />File GOLD nno. ' <br /> <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />'' '~° <br />Property Location (Street Address and Legal Description): ~l7 S ~ +-I iS <br />