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Ju1.25- 2005 3 :51PM MCCOMBS FRANK ROOS ASSOC <br />No.7312 P: 2/2 <br />DEVELOPER DEPOSIT APPLICATION <br />City of Little Canada <br />515 Little Canada Road East - Little Canada, MN 55117 -1600 <br />651- 766 -4029 (Fax 651- 766 -4048) <br />www.d.little-canada.mn.us <br />Deposit# /a(p� <br />Applicant's Name Address Phone 4 <br />.-1PNN t1 * 2aS:t4.. CAA* C t -t-rr' 4251- z <br />- 4t, <br />ft <br />Omer's Name Address Phone!? <br />Property Location (street address and legal description. if known) <br />•� <br />G.4N 6:>1) — R S., r ► ' ,_al ♦ a V S. t t <br />ii <br />Description and/or Reason for Request (cite ordinance sections, if known): <br />Via I4L e.l c a. o P ua r-t Pi-e t ?to reere Is-rm <br />.•� �S�e. wry, <br />In signing this application, I hereby acknowledge <br />that I have read and fully understand the <br />applicable provisions of the Zoning and <br />Subdivision Ordinances and current <br />administrativc procedures. I further acknowledge <br />the fee explanation as outlined in the application <br />procedures and hereby agree to pay all <br />statements received from the city pertaining to <br />additi.nal applicatiot •• �pcnse. <br />z //A4 / / <br />ACTION REQUESTED (check all that apply) <br />Architectural Review <br />y` <br />Concept Review <br />/O() <br />; — <br />Conditional Use Permit <br />Final Plat <br />Planned Unit Development <br />Preliminary Plat <br />' <br />CA SiEaature e pplicanL i{jnot 5pperty Owner <br />if �0 %7 _ t J <br />1--, /lv <br />Subdivision <br />i' ignature of Property Owner <br />Text Amendment <br />7- L_6S <br />Variance <br />Date <br />Zoning District Amendment <br />Other: <br />Total Deposit S <br />06) <br />i -- <br />