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Little Canada, Minnesota <br />APPLICAI"ION FORM <br />Applicant <br />Owner <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />e~Cs' l~~c~zeis <br />(Name) <br />~S ,~//dze/s <br />(Name) <br />Property Location (Street Address and Legal Description): <br />'~ 324G lui~n La,~o /2oa~~ <br />"D 004[ , G/1> ~. 3 Wa <br />~T ° %~..7~~d <br />PAID ~ ~~~ <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision ~ 7D~ <br />Planned Unit Development <br />Plan Review <br />~im.m l.a <br />' (Address) <br />r~~ <br />(Address) <br />(Phone) <br />-4-d/- <br />(Phone) <br />Shed M a School f~isf; "62~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />~c e c~_ _ S~~i v l Sl 0~2 t~ /~20 ve d rod eY' Y~ y ~/nG <br />Gvde <br /> <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ina 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 />r <br />"i <br />,~_o~~ 9-~ 3 -oz. <br />(Signature of Applicant (Date) <br />wHITC---Office CANAPY-Customer PINK-File GOLD-Planner .,j~€~,e., io <br />