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06/01/2005 13:30 6517664048 <br />CITY LITTLE CANADA <br />Little Canada, Minnesota <br />APPLICATION FORM <br />°'�����,PAGE 01 / S-7 <br />1 \� <br />PAID,zCo 6 <br />Rec No <br />t <br />Comprehensive Plan Amendment Conditional Use Permit 5C0 <br />Zoning District Amendment Variance `,yc, <br />Text Amendment Subdivision <br />Other . Planned Unit Development <br />Plan Review <br />Applicant <br />(Name) / (Address) (Phone) <br />Owner 4et d»f& f a*ns ! ke . i-%0 rif4d.it-fi' • vill2-64AAa%, tan/ (os1- 0°`4 -�12, <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />21510 JM'dd,c gtf • Ct' Ca a d& < to &J <br />l , { l z 111064- I . ect-- Jg ua.mx%04-04 X1'6 ( tga <br />Description and /or Reason.for Request.(Cite Ordinance Sections): <br />Cocci A <br />ifl <br />66,24$444) <br />14- -6 Q 9t Sal S3 <br />ui 1,S( 7162 -r7b <br />br( ¥gsapcz_ <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 ert p 'ning to additional applica- <br />tion expense. J <br />(Signature of Applicant)/ �` (Date) <br />WI- f1TE- Office CANARY— Gtotomer PINK —File GOLD — Planner / /- ��� �' ��"^�.... r ya(rei <br />