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Little Canada, Minnesota <br />Applicant <br />~~~r <br />PAID ~<~DO <br />APPLICATION FORM( Rec, No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~~ <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Gi ~L( <br />(Name) <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />~~(~~_~.~~~~~ tic. ~~iov ,~ic~ ~r~~~~r ~~i. ~~~. ~~~u <br />(Address) <br />owner ~~lll'N~)c"L ~.. /Y1E~~c~~/ 5k~'l7 ~CCN2~~>~E i~,~. !~P[.`a <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />~I,~.~l~D.~~ <br />(Phone) <br />~9ao 2ici; .5/zi/cr~ C(rr(_~ ~~~t(~i» >~~1 ~~~~~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir •nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ii a application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />~~ <br />t ~~ ~' ~ ~~lP ~O`~ <br />(Signature of Applicant) (Date) <br />WHITE-Office CANAn Y-Customer PINK-File GOLD-Planner .,.p,Y-„~.ngi <br />