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~' `? 914 <br />Little Canada, 1Vlinnesota PAID ~s~c? <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit ~~S~C% <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant 1,~U`<~ ~. ~U~~ J ~ ~U`7/ M1-l. Fr~'-i'~~ ,4~1 - ~S/-a31-.~0 ~ <br />(Name) ~ `~dless) ~/~~ \ ` ~1~ (Phonel <br />Owner ~'~~ <br /> <br />(Name) ~ 8~ dr ~~~ ~ 1 rd <br />Property Location (Street Address and Legal Descriptionl: V <br />;~t~~IFY~l~ ''G,l r~- <br />(Phonel <br /> <br />Description and/or Reason for Request (Cite Ordinance Sectionsl: <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ino and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />is :application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. ~'~ <br />Page 4 `~~- ~/ /y O ~ <br />!~ iDate) <br />WHITE-Oftice CANARY-Customer PINK-File GOLD-?!a~~~~~, „ac~Ao;ini <br />