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1~~ -- 879 <br />Little Canada, Minnesota PAID ~SO~ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />_ y~ Other ~ ~~/ <br />Applicant <br />(Name) <br />Owner ~~ ~{,Y~ -~' ;~~~ <br />(Name) <br />Property Location {Street Address and Legal Description): <br />(Address) <br />(Address) <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />L~) - <br />- CAS ~- , <br />~`s' ~- <br />(Phone) <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections): <br /> <br />- - nn r, l , , , a, - . <br /> <br /> <br />I ~, ~~~ ~ - <br />I <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 />i. .e application procedures and hereby agree to pay-alJ\statements received from the City pertaining to additional applica- <br />tion expense. ~ r-, ~~. -~ <br />~~• ~ ~ ~ ~~ 1, <br />Page 1 ~~f~.-~~~ -~ ~ ~/l~--L~,:, <br />(: ~ ~ (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner i ~ .- uio <br />