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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID a61:C <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 />v/ Plan Review <br />Applicant 5\e e: &n 11/ y �%.vn L.�k (y0n5 -u L'T-.cgn <br />(Name) (Address) <br />Owner IQ v v1 s\-e; na rk- <br />(Name) <br />Property Location (Street Address and Legal Description): <br />S6_ Jl/w" <br />c g C <br />\_ri - ar -a/ ,e €L,;the <br />/ <br />63) X34 V,S-y(ghOne) C. 7 <br />shore. ec! 4-14t ( nl,dr, (4 CO r fJ"SQ- <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />iL <br />ca <br />1 �� c, kid t YI'�ert <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />he application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />Lion expense. <br />57/6 —d7 <br />(Signature of Applicant (Date) <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner �e°.° <br />