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f~ <br />Little Canada, Minnesota PAID <br />~d`.' R R it <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant Sck~t~ S~+tS`x~y alo'a-'a 'S'ac-ics~,,.S~- f~~t,~-~{,ga.~-1x50 <br />{Name) (Address) (Phone) <br />Owner ~_ ~ ~~ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections?: <br /> <br /> <br />V)LtC ew G'C h.non o.JFt.,~ ~ C7v ~~4-0..SA V.~t` 1W'4"'y~ l.~Y AAJ~y~l4`t~~i..o~r}- <br />~MO_4~'S O-L >n V\4A.A--S ~] C~-~.~7 `'~ZTf~,.C'Ct"tC~ GJ~+.a ~.( eenn ..su~^-t~~~"T52fwJ' Lis-2 <br />_.. ~~A~AAA.T" ~~11~\-P lw r-e f~.DAluZt w..n C~CG V.~M .w..~...,. n .. ~..e_ . <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. I further acknowledge the fee explanation as outlined <br />i~ '~e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t. .expense. <br />~l <br />Page 58 ~`~~~~ <br />ant) (Date) <br />