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Little Canada, Minnesota <br />APPLICATION FORM <br />ATE - 875 <br />PA10 ~~SC <br />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 />Applicant 6~ G 01J r Y2 Ui 1 d, YIN <br />(~ <br />Owner JQ (Name) <br />-r~ d I t-y ~ I ~`t <br />~Lt.~.~P.YU.~. I `i' J (Addre/!ss) <br />LQS-~- l..C~_lfl <br />~ n /~ r~ (Phone) <br />IC.f,I rJ d 1.~ i{t~-~-j~(i~.{~ <br />~~~r ~C~ <br /> <br />Property Lo <br />_~ y~ (Name) <br />cation (Street Address and Legal Description) <br />C-as-4 Cou.~-k.,. Rc~ ~ ~. (Address) <br />: <br />l%U-~--E-~ c~-n (Phone) <br /> <br />a~ a, )M IJ ~t~,~-~(~~.~~ <br /> <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />1,~1~ a ~~ SY~olill-~rb ~ti ~~,n~ c~ C~.e~~ ~ie~so~ O ~-.e 1 or~,1 n~S ~k~ ~~ <br /> <br />r-- a. 5 ~.~~ i 55 i.t.'+.. i <br />In signingrt is app icatton, I here ~ acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ii ~d Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in ~~ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. 1 C(,Ck7)[l~ /,~ <br />Page 1 ~-/~/CZ<~ <br />dicantl (Date) <br />WHITE-Office CANARY-Customer PINK-File Vu LU-runner ,~:;b~uo <br />