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Little Canada, Minnesota <br />APPLICATION FORM <br />N? /6 3 <br />PAID $4000 <br />Rec. No. <br />Comprehensive Plan Amendment X Conditional Use Permit <br />Zoning District Amendment — Variance <br />Text Amendment —. Subdivision <br />Other Planned Unit Development <br />_ Plan Review <br />Applicant _Ne J C)h w�q�_4%;,'Jess 1AtAirivettrs t LLL 2.i1S2.4it }Je. S Y11nneAreh: i ) SS Hof, 612.721- 1((0 <br />(Name) (Address) (Phone) <br />Owner r1 +Y10/Ett Qc JtAi r t"-(L, LA-e 2NZa t(t.wlert <br />(Name) <br />S4r. NE rvAntritsitiwsS413 211-37)- 0123 <br />ddress) (Phone) <br />Property Location (Street Address and Legal Description) <br />325-0 „Cress, S{ ✓eef' L;1He Cav,iss M1✓ cc 117 <br />Lne,S LCS..1 ^ S.wJt,y '4 /Ry 1 ' h otY0.„dAis (r'Se. 2) <br />Description and/or Reason for Request (Cite Ordinance Sections) <br />IS-01 , 1 II � <br />Cons -✓�n.F 4r1°t tide_ G ISO fl1 10'Ole. t✓I✓t)CIS CDt+.,sia'11Cwj,enS 'rN( LJI k 12/K241 <br />!rtGN�SkGITW ,,.Viet, kit is (± _coo 8M G,+ 41e- s45of egoelt I. OniL,Vor LJ.wke-Ss <br />3, e1. rcS <br />VOJi mR tZp1)+t't,�,,,� ,.J:(1.I C» (owmvoi._v.1 414't5 COJale L b>)e Ca.nkut'\ AAA ntahq <br />T ,A✓Aw StJ 0 903.IM 0• K-.. (4 Loot. Sek <br />( \JW !e.46' -fer 4y) 1tr chat 1s, <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE - Office CANARY- Customer PINK -File <br />} i ml -hr' ('„',1kK H (I>rrL J) J os <br />(Date) <br />(Signature of Applicant) <br />GOLD - Planner <br />