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-- <br />~.c~ -- 9 4 5 <br />Little Canada, Minnesota PAID ~°~ <br />APPLICA~f ION FORM Rec. No. <br />Comprehensive Plan Amendment _ ~ Conditional Use Permit <br />Zoning District Amendment Variance <br />_~-- Text Amendment <br />Other <br />Applicant <br />Owner <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) ~;ry~~~,~, NIr~,Ss~i~ (Phone) <br />Name) ' (Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />.~ <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 />in tea application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ti< xpense. <br />L._ ...._._ ~ `~ ~.~ 0..2 <br />(Signa re of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GO LO-Planner - $ - ,`~~ ~o <br />