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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />~"~' _- 900 <br />PAID `~J~ ~/~ <br />Rec. No. <br />Conditional Use Permit <br />__~ Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant __f SGE~'UG~i~-l~/ /-f~SR~-~'f-~~-~1 ( b S~~i-~'~~ 0~~-1 <br />(Name) (Address) /" (Phone) <br />Owner r~~-C~~ /``213--N /~`13f~ f~ ~-iA-I'~1 l~~'(~ 1-f-`~' U C?~' ~,¢~7 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />~.~~/ ~` c~~~'~aai an7n <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />n <br />,_ r.~ <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 />i ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t,_.~ expense. <br />WHITE-Office CANARY-Customer PINK-File, G( <br />~.--- <br />1~~~.~ ;.4 h ~.~~,1>~ - <br />Page 28 nt) <br />,;- ~ _c,/ <br />(Date) <br /><:~, ~o <br />