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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant \L'ILLi,L -, <br />(Name) <br />Owner <br />(Name) <br />N? -1(1f1 <br />PAID SCr) <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />4701 CL,asrztc- kit 'WMa t2AmAA$4.4 1-551' +79 Ot3 <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />VS( sT 6,.04 i PAD r 15 Z <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Ann vnowe.d . ottik -a 5R\Ct. <br />n 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 s te ntr received fr. he City pertaining to additional applica- <br />:ion expense. / / / / <br />(Signtani'rZ of Applicant) <br />VHITE — Office CANARY — Custorner PINK —Pile GOLD — Planner <br />(Date) <br />