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Little Canada, Minnesota <br />APPLICATION FORM <br />dress) <br />- Comprehensive Plan Amendment Conditional Use Permit <br />_ Zoning District Amendment Variance <br />Text Amendment ~ Subdivision <br />Other Planned Unit Development (P/2 - <br />7.59 -(o/loJ' <br />~``~~~ / Plan Review ssj/3 <br />cS~`/~E~S7,oq~ (a`~~.~2fC~-.ST.~.CC'~ 325. ~. oc,~~rss6 ~3/vc~ ar~v.Y/r~~rt <br />Applicant ~ "''c- <br />ame) <br />Owner~~~ E <br />(Name) <br />Property Location (Street Address and Legal Description): <br />)~ <br />,. <br />/o <7 <br />~' <br />PAID ~ )Dj,~ <br />Rec. No. <br />(Phone) <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br /> <br />~' <br />~ ~ ~~~ ., <br />4 <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 />it ,, application procedures prd hereby gr~e to~pay all statements received from the City pertaining to additional applica- <br />tic. axpense. <br />- ~• ~ / <br />/~ `X/ ~J <br />(Signature of Applicant) (Date) <br />'NHITE- ice CANA HY- usto mer PINK-File GOLD-Planner •=•1ii~ <br />