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~' - - 9~4 <br />Little Canada, Minnesota PAID e~ 700 <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant V ~CG <br />(Name) <br />Owner`f "~'y N~~~t <br />(Name) <br /> <br />Property Location (Street Address and Legal Description): <br />S~Ii7 <br />a~da 6S1-~v 4=5.~ <br />(Phone) <br />T'` h e- w Q^ s-I- c° ~ -yep-(- o -~- L.o~l-S L 6 ~ ~.d. ~ ~-1 BC..n cK ~K- <br />`'" ` ~ ~" (J l 1T- ~.q ~~ l._ 1'~ V T 1 ,1 ~ I ~ ~' Rin l / ri/~ ~hnCv.. /` r1i. _ .~-r f~.r w 1 <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />G <br />,~ Z 5 L~o~ <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />6s~-7'7l -g°Io8 <br />2121 SLoN~I St. i~A~L~w~ M~ 5~ <br />(Address) (Phone) <br />~D Li}~'1 <br />(Address) <br />JUN 19 2003 <br />~ LI !!: 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 />in '' application procedures and hereby agree to pay I statements received from the City pertaining to additional applica- <br />tio. xpense. (I _ /1 <br />L. ~ . r ?~f/JI L~.11J~~ ~ / ~ ~ ~U 3 <br />(Signature of Applicant) Date) <br />WHITE-Office CANA(4Y-Customer PINK-File GO LU-Planner <br />..a.~~R. nuq <br />