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Th <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N° <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Nt3So <br />\pplicant Oe-e°6715 nark 2■/210,- <br />(Name) (Address) <br />Iwner ,4!/ /2) Z9wer-S 3; /'/9,op /0» <br />(Name) (Address) <br />roperty Location (Street Address and Legal Description): <br />`tea 7/2/.40/ 4924e e G4'rn9ci ,1l 5'3%/7 <br />©/ /J/ 6 /oc / /'Jcts'U,✓ 4& /s scy coU•, <br />(Phone) <br />g(57- 7,97 -0971/ <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />ta-ir <br />In ' 'nine this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />.d Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />i the application procedures and hereby agree to pa,, all statements received from the City pertaining to additional applica- <br />tion expense. <br />►4�� <br />(Signatur • p. cant) <br />S 22 -O <br />(Date) <br />