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~_~ ~~_ <br />l~i~~le Canada, Minnesota PAIp ~~_ ___. <br />AF'F'~,ICATION FORM Re~.I~~.___~_______ __. <br />Comprehensive Plan Amendrent -_....____ Conditional Use Permit <br />Zonino District Arnendrnent <br />Text Amendment <br />Other <br />Variance <br />.___..__- Subdivision <br />~._.__ Planna:d Unit Development <br />Plan Review <br />Applicant _~Q,,{~ ~~',I_$S } I'f~VS - -=- ~ ~ ~S_Z,~'_~2r~~y~~r~_" "~~~-') ~~ <br />(Names /~ ~~srf3~Y~31 ~G4dtlress) (~honei <br />Owner _`_-_!-^ ~' IV <br />(N <br />Property Location (StrLet Address and Leyal Description}; <br />a ~?-y1_.~_. <br /> <br />Description andior Reason for Request (Cite Ordinance Sections): <br />11 1 (~ ' <br />__..~.~.L___ .....___..._._._.~ ~.__.___.._. _- ______..____.____~_.__~----~1~_--__~._______--__-_- <br />Ir grainy this application, I hereby acknowledge that I have read 'and fully understand the applicable provisions of the Zorr <br />i~ :Id Subdivision Urdinant:es and current administrative procedures. I Further acknowledge Che tee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applrca <br />tiara expense. <br />(Signature ~f Appliranti ~ (~7tltel <br />W HI7E--OtTce CANARY-(: ~,eto m~sr PINK-File GO I,U--planner re'w'~y <br />