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~~' .._..926 <br />Little Canada, Minnesota PAID ~~~~ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~~60 <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other ~~ly~t-~ y-~Q,cc)' Planned Unit Development <br />Plan Review <br />Applicant ~`~ ~Y. rn w w°J ~ o • v',~b' ~J ~ 1 ~ `'~ I- CE d~C~'w~ u~ a~ ~ 1 ~ _L) j ~) ~ ~') ;~ <br />(Name) pp ¢~ (Address) \ (Phone) <br />Owner ~ w ~ w1 u u~ b 1~ ®~ 1a ~.l 2~t9 y~ ~ ~ ~'i ~'~ ~ ~ ri c r mil- F, I~ J (- ~7'~ `~ ? ~ c? ~` <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />.-~ „_ <br />~ ~ E t"",~ ~ r~~_y. T ir1 v1 „' ~~i 2 `~ 2-'~--- 'Ct~ ~O ~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir^ and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. ~~ , <br />~~, g bt ~ ~ a..~.o V~r ' <br />(Signature of Applicant) (Dat~ <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ~&-.,,,m <br />