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~~' _- ~~3 <br />Little Canada, Minnesota PAID ~i Y~=~=> <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />(Name <br />Owner ~i'~,>i~~ ~° ,~~- <br />(Name) C <br />Property Location (Street Address and Leg~~Description): <br /> <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />~~ ~aJ=l 7 <br />(Address) / (Phone) <br />(Address) <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />/~~i i <br />o G~~ <br />J , !i~//dpi %il-L ~'' /-, C/l'~7~/`d' G~r~; i~.~ ~ ~--(G /tj <br />~ / <br />~' / ~~_ <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 s application procedures and hereby agree to pay all stateme~ats received from the City pertaining to additional applica- <br />i <br />tion expense. ~ . ~ -~ , <br />/ / <br />%~'%i i <br />~; <br />(Signature of Applicant) /;~ , ate) <br />WHITE-Office CANAFY-Customer PINK-File GOLD-Plannar t~~ ~ ~ .~~~.in <br />