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<br />Lit/p~tl®e Can/a°d' a, pIVlinnes®ta PAID ~_~szr `'° <br />B'~I~~L~~/rA 1'®IV ~®I~4lbl Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />~.. <br />Applicant 1 ~ ~J <br />(Name) <br />Owner ~~~ ~'UUNI=~ <br />(Name) <br />~~ <br />u <br />Property Location (Street Address and Legal Description): <br />>S ~ ~. l'T L~' ~ r9~`%VtD~9 ~~~~ ~~ ~A <br />(Address) (Phone) <br />(Address) (Phone) <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />ti~W c~~~~i;s, 1-~~JD)T~~N w)~~ a~c~T t~~G;~~)~~s~ p~ ~~~J <br />_1'~r ~~~ F4~ lyON -C~~ ~o~(:wi'~ N G- -:~~1` d~ (~LtL 0 LNG <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 />it application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signatu of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner / ,.~~,ro <br />