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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />Owner <br />(Name) <br />(Name) <br />Rz <br />Property Location (Street Address and Legal Description): <br />2 q C0 <br />PAID 49(z) <br />Rec, No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />60 douAiik Graf r <br />(Address) (Phone)G 1 Ziy <br />n I v p /� / La 7 T7 <br />I pos J ``�� 4c r i a , 1 CtrvtC d! Pc—a <br />(Address) RosQu II I e. MN I (Phone) <br />Sec 6 i zq 2 22 Tvo <br />N /z <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />7NTf f21 Of Pro c�r`�'� <br />SOLD —' (O c rr )S IU2 SAL.L <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 />it application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tit... expense. <br />Ygi <br />(Sign ure ofpplicant <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner <br />(Date) <br />