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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />x <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />/ V2 e <br />PA I P c-4 <br />Rec No <br />Conditional Use Permit '45-3S6 <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />a7 C4 e2lakti kV loot/ <br />(Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />cr /G 14+ --/-0 .bui Lel q 7 4449 e. <br />a c/ Wood cu& KLn $ 4 of /n Tr?c <br />M/ E' C irl p Y. I 4, A-, vl S !'1 0 m E.. 1 . 5t? et( ,e'c w< ��(- <br />a e <br />TiAe )2../5--, , A274 a G,a/ Go,242.P <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signet e of Applicant) (Date) <br />WHITE —Ot lce CANARY— Customer PINK —FI le GOLD — Planner <br />