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A pplicant <br />caner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N? 1047 <br />PAID i_;-CC) <br />Rec. No <br />Comprehensive Plan Amendment / Conditional Use Permit'���' <br />Zoning District Amendment Variance <br />Text Amendment — Subdivisions %DD <br />Other Planned Unit Development <br />Plan Review <br />(Namel <br />(Name) <br />but 64.5 dot inscor, iit-c , h <br />�✓ (Address) <br />c.� <br />(Phone) <br />2 3L/6 l4-e/ , 651 -7o7 <br />(Address) (Phone) <br />operty Location (Street Address and Legal Description): <br />2i <br />' ice-• vvSs <br />YYU, <br />Jde,./1 -+- b=1� <br />IU�Vw.STIye2 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />CLiTd cS) U 5 )% kteg F— <br />Sty, LA- <br />rX3p i- cfkta . <br />c joning this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />nc i Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />n ie application procedures and hereby agree to pay all statements received From the City pertaining to additional applica- <br />n expense. <br />(Signaturd of Ap9)li cant ) ._./A <br />di HI'rE— Office (:ANAfl Y— i;usto mer PINK —f=ile ,)G7(bW 5 V1�'-��' <br />GOLD—Planner <br />' /s.y /t- ) <br />(Date) <br />