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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />/ /T c- \I! A- /A' <br />(Name) <br />/rj <br />/ l% <br />PAID <br />N? 1050 <br />sui <br />Rec. No <br />Conditional Use Permi S60 <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />/' ,A, e,V //,� c:�: z L - <br />, <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />�(- /f C, <br />(Address) <br />(Phone) <br />/K. <br />(Phone) <br />ffrs <br />;cription and /or Reason for Request (Cite Ordinance Sections): <br />ZI-Lekr;tra /6?--n.t-te-_-/--- <br />1 gning this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />u ind Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />i r.! Dplication procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />o L„pense. <br />/ <br />(Signature of Applicant) (Date) <br />H F— Office CANARY — Customer PINK Ile GOLD— Planner <br />