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Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Nt? 1048 <br />PA I D <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />k-cL4c -- :g''\C'Sf[! C- 1dGL 4 Ld4{a--1'44;e4— <br />(Name) (Address) <br />Owner�Glr� Z� <br />ft" <br />+5 ' (--2"1- -C.1)(27 (4) <br />(Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />SE cove ✓. "b k(61A-4) k.c.c_ A" - ,:u-Lok 14i �.ect'r2e S� - <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />S et ct, OA c e is 1/4. p?fl � i F a.174, ( 61-A.17 c; <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />g and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />it ) application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />' expense. <br />(Signature of Appiicant)ke, <br />{ITE— Offiee CANARY — Customer PINK —File GOLD — Planner <br />(Date) <br />