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(_ '^ ~-- <br />Little Canada, Minnesota PAID ~sd ad <br />APPL1CATlON FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~ ~SU <br />Applicant <br />Zoning District Amendment <br />Text Amendment <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Other <br />(Name) <br /> <br />(Address) <br /> <br />7Yi'%' <br />(Phone) <br />Owner ~C( v11 ~... <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />r ~ <br />/ ~/ ~- Z ~/ s~ ~( <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />in nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ire ~ application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />/~\ <br />Page 1 <br />'.^JHIT~-J~ ..._ _.;NAnY-.,,s;o mer 'JK--~!2 ~u L:-~'a nr er <br />/'\ <br />i <br />~~ <br />1-.~ -O/ <br />Day=, <br />