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~~ 3 / <br />_,~,~. <br />Little Canada, Minnesota PAID ~c~Q___ <br />APPLICATIO~1 FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant '~~u.~,es ~ G~9a ,f/a/ .30`J/ ff,~c„~< S~i<ef 6t5/- ~f9.0~90~2 <br />(Name) (Address) (Phone) <br />Owner <br />(Name) <br />,$ p ~.... u J 4 6 <br />(Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />3 d 9/ /~ y ~~ d(~ S f~ « f- Thy sa ~, fti 8 d f<< f 7~ t~~ ~ fh 3 6 6 <br /> <br />~: <br />G> f /3 <br />s S~, d ~;,,,' <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />e <br />y <br />a /7 d <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 *' -application procedures and hereby agree to pay all statements received from the Citypertaining to additional applica- <br />tic ,cpense. <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner <br />~o <br />