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Si f/ r/ ~~ -- ~'~6 <br />Little Canada, Minnesota PAID ~ac~ <br />APPLaCATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment ~~ Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />,- <br />Applicant ~~~/yr9L-~ 1/f~/ ~N ~~ ~~1~` =~1 ~,~' CJ~V~ ~-~I-~~J9-/"¢~°j /~'~? <br />(Name) (Address) (Phone) <br />Owner <br />(Name) <br />(Address) <br />° :'~: <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />2 ~~~c ~~ <br /> <br />~ii>~~> ~ vim ~ - <br />-e <br />~: r> ~d <br />~~~ <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i~ and Subdivision Ordinances and current administrative procedures.,l'f~rther acknowledge the fee explanation as outlined <br />i, le application procedures and hereby agree to pay all statements r`eceived,fFom the City pertaining to additional applica- <br />tion expense. ~~.' ii/ ~ ,-'r <br />Page 9 ~' '~~~~ / -~~~-!'!' <br />ant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GO w-runner - ..ar~'~nfin <br />