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g~~La L.~j'~}~. LS i.iii ~ J ~~Ut~. ~. <br />Little Canada, Minnesota <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other Cortecp'~ <br />`~~~s ~\~~8e.1 83580 <br />Applicant 11~ ~ ~QX' 1 San ~v V 1'~t <br />(Name) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />~..~'s~~n,-eve. W,R,L. 55/l o <br />(Address) $$¢¢q (Phone) 763-7~4 2.52 <br />(Address) <br />(Phone) <br />3 a 5O Tw ~ ~ La..lz~..- R ~ . <br />., <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />N ~~ <br />or~cr~~ .~ Y`e.V~; a..l 4- <br />on~~~ <br />ii ~~ <br />CuKcc~~ ~ rGV~~ 7- l-o~- S~~ d;U <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />inn ,d Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in application procedures and hereby agree to pay all tements received from the City pertaining to additional applica- <br />tion expense. <br />~~ ~a-a3-o2 <br />(Signature of Applicant) (Date) <br />WHITE-Offire CANARY-Customer PINK-File GOLD-Planner ~=d' ~~ <br />