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m. ~ _~ ~~j _ _.922 <br />Little Canada, Minnesota PAID~~/f ~Do <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~5~~ <br />Zoning District Amendment~SV~ Variance <br />Text Amendment <br />Other <br />Applicant !' ~C(~ <br />(Name) <br />Owner ~~ ~- ~ S G <br />(Name) <br />i1 <br />Plan Review <br />X77 ~~,a~~ ~~u~ ~ ~` <br />(Address) (Phone) <br />S-Y, <br />(Address) <br />Property Location (Street Address and Legal <br />•- <br /> <br />C (~ C~i~L2G~ol <br />(Phone) <br />Itit ~ 537/ ~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />~ ru~c~i~~~i a <br />~r~; ~--~ <br />Gt~ <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 stateml~e/~/,r~y(~s received from the City pertaining to additional applica- <br />~~ <br />tw~I expense. L/ "' <br />(Signature of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ~~o <br />Subdivision <br />Planned Unit Development <br />~~~v <br />