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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment Z /\ Conditional Use Permit <br />gj,r? 110,0 <br />PA I D, 06') <br />Rec. No <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant MCH NET <br />(Name) <br />VM(Cf m L_ Pi gill <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />1 2445 5* STn -e &i ( 61.-1410 ) MN/ <br />(Address) & ) '4;0 O (Po <br />Owner vAAyt ‘Qft ).,,,J SEN <br />(Name) <br />/0301 w 000 Crest' .17R1 VE N w <br />COON g. p) ,W■ 55453 (Phone) <br />-763- W9•363c <br />Property Location (Street Address and Legal Description): <br />3 Zo ( Corti; 2124 uG <br />�O f fL POSE 'ems /41T7411-(e19 5u'�417 5Y <br />N 5. J o #tN4orJ 9 ro !2//4(c4- <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />• irfri Mniex)Ot iaxr Az? ?trn Trap frtse5 -p I3W 206)004 <br />2. TT Cr n END 1M S %.JT : L.eCT RoM ► G S I (- N j fl 55i 6 E ,o D <br />7, Go%)0(714)AL (t5e. G72.144rT': St 6N 19/161446e <br />G: COP O ITtONfL uSe f'eZvii rf': [goof. o p . PA+°Ki 6)k <br />c\OF-iii.toeJt (ZG,oc $70 521 (c -ytt3 S►6rJ <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 />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />23. (77 <br />(Signature of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner �yio <br />