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Little Canada, Minnesota PAID ~ »> <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant / ~ ~p n~udlCc /~ i ~~ <br />(Name) <br />_ Variance <br />X Subdivision <br />Planned Unit Development <br />Plan Review <br />>LV yak ~~~k ~-~~~~~fs <br />e s, /s'lc_, /358/ /U. -Sf Mn) Scii~f ~ <br />(Address) (Phone) (c5~- Z7S-o~S 0 <br />Owner `JCZ.~me- a.s C:c loo~e_ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legai Description): <br />I Y1~ ~~cr~l~ -'/5 c~F_LQ I~,fo<1'~ Z I~liof-~(a iJ ,~k cca'1r~ L~-Ft I <br />~'~~'l(`GUG~n 23 I or k P I~Ir~-{-h ~~ P1~11-}S ~ {~GMSC(~' CCi"UI'L`~-~-i f~leUll9~ S7i~ <br />Description and/or Reason for Request (Cite Ordinance Sectional: <br />%v /- - / <br />~/va ~~ ~. .5~~1io /' (~ n~~~v79 /7U/l/~~d7Q <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />inr ~~d Subdivision Ordinances and current administrative procedures. I further ledge the fee explanation as outlined <br />in application procedures and hereby agree to pay all statements receive"" froCity pertaining to additional applica- <br />tion expense. <br />~~_ <br />Page ~ ~~"'~~ , -~?9--~Uj <br />,.,.,,..allc) iDate) <br />NHITE-Office CANARY-Customer PINK-mile 30L ~-Fanner ~ -.;~,i~, <br />