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/ - ._ <br />ATE 886 <br />Little Canada, Minnesota PAID ~>~ =- <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment ~ Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />~r/t viz-~c~~3nkl <br />Applicant /f J. (./~!/s ~,os,l jA1!' /3/OG.~wu 4l~/ %/.!i>'~S~+iL.ic~ ~Mn) s-.Si/o O~G G.Sr - yZ9-i3 ~ 3 <br />(Name) ~ (Address) (Phone) <br />Owner <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />S/ bYS'- 20 <br />(Phone) <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />c .+ <br />1. <br /> <br />.' c 1~ <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ii, -,ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />~.~i i vo, ~~/,, ao~a <br />Page 23 i (Date) <br />WHITE-Office CANARY-Customer PINK-File GO LC ., ~a <br />