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~.o --~~5 <br />Litpptle Canada, Minnes®ta PAID ~SJ <br />!'\~~LIC/'~~I®~ FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Variance <br />Subdivision <br />Other ~ is-ti.) Planned Unit Development <br />Plan Review <br />Applicant~GLf'~Gv~'-~ r.i d`"i OY{SS/Cm0_ / /~Q~/~ ~SS~OC,/GZ n~}-~ % h~ <br />(Name) ~~ ~ ~.~ ~ CP .~frP~~ddr~USPvi %/P ~-t'C/ (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />'-cr ~/.C <br />(Address) <br />C/o ~J'Br>QP <br />G-Si -~/~'~ ,- <br />S C3~n~u ~ S' G+i hb iP ~~ <br /> <br />L <br />- / 7~~~< <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br /> <br /> <br /> <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir end Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ii e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />`~ C,J ~~ <br />(S' nature of Appl~ (Date) <br />WHITE--0ffice CANARY-Cus[o mer PINK.-File GOLD-Planner .., ~,mi <br />