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~~ -io32 <br />Little Canada, Minnesota PAID ,G~co <br />APPLICATION 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 _Sh~2~~ ~4~ Jl"~2~~t^ 1J 5 r?`y'y ~i ~ ~5~~ ~($$ ~ ~,~1£~ <br />(Name) (Address) (Phone) <br />Owner S~a/1(~.N7lJ , I/UC / 155 1~'~i-f-~y S^ sit yyn ~'e/~Zt tA,~t ~7`~'td~i ~ZU6~ (~~Y-b'iyo <br />(Name) ~ (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />' ~3 /kJ~/~ nt/(..CG (~i 1~.it/i}L rji ~.N/) GI C',L~/VLyiyj'lr~ /(/L'i- Y"-G'Z 'h i~r{:9 'iy GC/L( <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 *he application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />expense. <br />~ ~_ ~'_u <br />(Signature of Applicant) (Date) <br />WHITE-Office CANAr1Y-Customer PINK-File GOLD-Planner ~u <br /><•a.. <br />