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~+T`.' 884 <br />Little Canada, Minnesota PAID ~~11'..~0 <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance '' --7 <br />Text Amendment -4- Subdivision Y ~~'~ '" /~D <br />Other Planned Unit Development <br />Plan Review <br />2~ 2'~ GOVa~ (IZ`i` p~l~~ <br />Applicant ~, {~ ~RJ• (r • ~~ CJ ~1" JI ~G' ~ oCo L l 1 (LE G/.~J~a~.l~ Cv'~ i -~fa7 -'~07 <br />(Name) (Address) (Phone) <br />Owner <br />~amG <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections): <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. I further acknowledge the fee explanation as outlined <br />fe application procedures and hereby agree to pay all state is eived from the City pertaining to additional applica- <br />tion expense. <br />Page 18 ~ Date) <br />WHITE-Office CANARY-Customer PINK-File GC __ m <br />