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Little Canada, Minnesota <br />APPLICATION FORM <br />N? 1060 <br />PAID C-75,3S C� <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />f i j <br />Plan Review <br />Applicant I k mitcp i /col e00r 1 Z ( <br />s/-9, 0a /v <br />(Name) <br />(Address) (Phone) <br />Owner Set. orA e %OVe <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />2.001 Coun-k/ -I J <br />\ &i. T 2,,„ <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />T ('a nc Ac z 903_0/0 Sers-} -:o n 903- z 3 , a-e,vt T <br />fit (2, ,n 2 cf) r C Rr L e� IJ � �G 11-(-', �l G1 n Ci -44\ /; lir-'6;sc, - <br />PP Gt�,.r',�1l <br />I signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i 3 and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in t, 1pplication procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tinr, - pense. <br />v <br />Te— Office CANARY — Customer PINK —File GOLD — Planner y--, <br />/ <br />(Signatyyre of Applicant) <br />,/ <br />/ <br />(Date) <br />�:J <br />