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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />Rec. No <br />a(9 <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />�,,, <br />Other Gr(1�c =it �'tG�h �� (Z'N .Planned Unit Development <br />Plan Review <br />�v,X6ze :(cuff U-s - us∎ - 51. -T•5-6 <br />(Na2: ) 12 0 127D sc (Address) (Phone) <br />T-TSbE3-z (42s(- i15 -ioL-(2 <br />(Name) (Address) (Phone) <br />Applicant <br />Owner <br />Property Location (Street Address and Legal Description): <br />C, 4 L---a r4 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />0,t e � � c- P1 a C C--C ✓, CAA) <br />n signing this application, I hereby acknowledge th end and fully understand the applicable provisions of the Zon- <br />ir id Subdivision Ordinances and current admi strative proce ores. I further acknowledge the fee explanation as outlined <br />ie application procedures and hereby agree ti pay all statem:n received from the City pertaining to additional applica- <br />ion expense. <br />(Signature of pplic:nt) <br />WHITE —Office CANARY — Customer PINK —File GOLD — Planner _� m <br />(Date) <br />