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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />3E! /WI <br />PAID 0° <br />Rec No <br />N./ Conditional Use Permit <br />N/ / Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant IOSC' C NC l �1 mac_ . a\ tJ-Th • <br />(Name) (Address) (Phone) <br />-." "i y hoc _�\ • c c� \e V L <br />Owner <br />(Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />\ <br />• \e C \cACA.\C <br />\ At Qc c\ &I, <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Th <br />C:�� \ <br />c \.c \C\\.-CM <br />\G' t \c <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. 1 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 />(Signature of Applicant) <br />WHITE— Office CANARY— Customer PINK —Rile GOLD— Planner <br />(Date; <br />