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~~ ~~ -- <br />.t~n 8'77 <br />Little Canada, Minnesota PAID ~ µ~~'" <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment x Variance <br />Text Amendment <br />Other <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant~c~~~ ~-"<<'--~ s <br />(Name) <br />~:~c ~.~ <br />(Address) <br />(Phone) <br /> <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />~~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />,.. ~. w <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir^ and Subdivision Ordinances and current administrative procedures. 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 />tion expense. <br />~~ i <br />,I <br />Page 5 ); ~ %(Date1 <br /> <br />WHITE-Office CANARY-Customer PINK-i•i le GO LIJ- .-~'~~im <br />