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i'~91^b/J1~02 1=; 59 65176F,Ji34G <br />~~ <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />~- Other /-~ i cti ~ /e ~ / - .._ ~ <br />/~c ;r".~ ~~~.:-r <br />~~ <br />Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />(Name) <br />a. ~ `Lc I <br />JIT'/ LITTLE :AI IAL:7 <br />FA aE I~ <br />I~T~' 9 51. <br />PAID _,J DO -~ <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />C~'p~~~~ ~ ~~ Q cap Tev~4 w <br />Plan Review <br />- Cs 3~- o~ta3 <br />(Address) <br />Owner I\7{~v~ .' ~ " ~t~. L`^.~=d. ~ 1,-.,:~d.._~ !~, } { <br />(Name) (Address) <br />Property Location (Street Address and Legal Description):- <br />(Phone) <br />~v>~~~ ~j 1~~~ j~ <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections}; <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 />.n the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant-)--_~' ((Dated _ <br />WHITE-Office CANARY-Customer OINK-File GO LO-Planner f_' <br />