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t~ ~ ~ <br />Little Canada, IVlinnesota PAID ~~sco <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />~ Zoning District Amendment <br />Variance <br />Text Amendment <br />Other <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant ~,'~-70;<,~ /4-+~/J...., /~Y. .L+H C. /C/L /~i//-~.L Ct..7`y'.Bi'v/ .v.G d J~~• y~-S',1~ <br />(Name) (Address) (Phone) <br />Owner ln.,o~ 7~~/, ry ~r-.,,.c~ !`'2.c x.4./7 ~cn,/~'-y ~'rL ~,J"~- /^b'~'-- /L/2., <br />(Name) (Address) (Phone) <br />Property Location (SJJtreet A/ddress and Le~gJa/(l Description): /{/ ~y~ /J ) p^/1J <br />Description and/or Reason for Request (Cite Ordinance//Sections): // jj.~~ <br />Chvl. il~ ~.w~ ~~ ~%'.,.~ c,c/s~'.~rP,/C, 1 ~ /~i ~ ~_ ~o G CCc~.rlaNy7~-' <br />i <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 />i ~e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t~_.~ expense. <br />'"-r°t <br />(Signature of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ~+><""c-m~~[~!i <br />