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~- <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />PAID <br />~~ -- 862 <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />%%~~ Subdivision <br />Other Planned Unit Development <br />Plan Review ~ A-(,! G~,LUL% ~'~- ~~~Y`r1 <br />II ,,_f I ~f' / ~ ~1 1 3/ <br />Applicant I'~=e_(~L~-(~t~l '~' I~~IL' ('~- ~~ It'I l I ~c~~ Y (~%~`~Q1~~ S~I~PS ~~atl ~~%~d <br />(Name) + ~(A`ddress) (Phone) ' l <br />Owner= 6'`~-ems ~~ b h-e ~ e , ¢~Kl -t+2- IQ Iva- C/~ h) z ~~ ~ L '~ I ' ~P 4 ~ -~ 7 ,fs~ ~/ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />,~I..~`~i.. ~c'~ ~Lc~c~i-cam: <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />i <br />In signing this application, I hereby acknowledge that I have read anr~fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedure . I further acknowledge the fee explanation as outlined <br />e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />twn expense. <br />~-~ ~/ ~~ <br />Page 54 ~' ~ ~~ ~~- <br />t) (Date) <br />WHITE-Office CANARY-Customer PINK-File GO'~~-Wanner .:+~o <br />