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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />/ /c2 <br />PAID' <br />Rec. No. <br />Comprehensive Han Amendment /Conditional Use Permit <br />'toning District Amendment Variance <br />Text Amendment Subdivision <br />Qther Planned Unit Development <br />Plan Review <br />rr <br />(Name) <br />�t��L ���- 1'tnG✓u1 <br />1 Or <br />(Address) <br />C4 C I — Lfl -45 <br />(Phone) <br />11 <br />(Name) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />2.,406 -K <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />("IA, <br />/O X <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zor <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outline <br />n the application procedures and hereby agree to pay aji'statements received from the City pertaining to additional applicz <br />tion expense. 1 1 <br />(Signature A/3pplicant) <br />(Date) <br />WHITE- office CANARY -- Customer PI NK—File GO LO—Planner <br />30 39Vd VGVNVO 311121 h1ID 840799LT99 ST :TT L003/6T/40 <br />