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Little Canada, Minnesota PAID ~~,~yo 00 <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />=1- Zoning District Amendment <br />Text Amendment <br />Other <br />~~- ~ -~ <br />Applicant e~/ ~' lPa~ <br />Owner ~~l"-~ ~~ "~`5~~~ JY <br />(Name) <br />Property Location (Street Address and Legal escription): <br />3~©~d GI ~'1 ~^ `~ fd C? <br />Variance <br />Subdivision <br />--~ Planned Unit Development <br />(Address) <br />Plan Review <br />~~43~(0 <br />~~ tVE <br />(Phone) <br />Description and/or Reason for Request (cite Ordinance Sections): .. <br />~ / ~ .., <br />C le'/ <br />In signing this application, I hereby acknowledge that I have read a <br />ing and Subdivision Ordinances and current administrative proced <br />in'~e application procedures and hereby agree to pay ~I stat me <br />ti ;xpense. ~~ <br />fully understand the applicable provisions of the Zon- <br />~rther acknowledge the fee explanation as outlined <br />ecelYed from the City pertaining to additional applica- <br />(Slgnat re f Applicant) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner <br />7 ~ a- <br />(bate) <br />~~~+ io <br />