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~ g~~4 gob <br />Applicant <br />APPLICATION FORM Rec. No <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Little Canada, Minnesota PAID ~ <br />Zoning District Amendment <br />Text Amendment <br />Other <br />(Name) <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) (Phone) <br />Owner f ~~~ ~ ~ ~P,~15 ~t f / ' r <br />(Name) ~- <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <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. 1 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 />tio~~ expense. <br />Page 1 I (Date) <br />WHITE-Office CANAfiY-Customer PINK-File GOLD- ~-a.~io <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />