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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other /\ Planned Unit Development <br />Plan Review <br />l- 750 S..9LA A QR. <br />613& L./ (2.81461 SUIR I <br />L t t`CL/_ C4NAbA r MAt . 5S ill <br />PAID <br />Sec. No, <br />Conditional Use Permit <br />1 13 kRRG'j \'•CCS <br />(Name) <br />ST JUDO MEO\ PYL tLQC. <br />(Name) (Address) <br />$coo <br />LiSL/^ P556 <br />(Phone) <br />6S! -q 3,23 ao <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />Pt44 SL -' tMo 4400 LtL to ST. J at MWlc&L cZkBQ»S Trahoo Law cartes <br />1-pc,- o Al tTT Mtr Co OWN R.aAD 8 t 11I fl .k UliJPbN / t- - SSStrj <br />seg LElil3L D65CRIPCtaw Arrti_619 )'rS CF}t$IT'A3I <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />Mji Itc6..o ?L iMM tL-u7 PNLI T DA-t6-0 'HALL I ST/ L992. <br />r`3S�o4x� 5i= pplTLC t t k5,dc ;MU 1-LAMtr'pAcT(51 l9.TG F4U.LL1t( <br />Ptt*os)=o ELSLUOINti LJccUJDt= A watt yiNATU-f Goa Six ap M.atqOFMcr, fl s' c1 <br />kb3D 1- AASOR.4.' L 5Pki -c. A RS /000 SP 2P dFttc1: A-e..t 4NI0 30oo sp cst <br />VV R-L:7 la -6US)= sptct= <br />061.11 -)NLYA LCY\ of- `Cli)= PLib Pi ct^-ss <br />SLt P1.)i i e F'L.cop. 141A)-4 M.13.) cam pzLt-m- <br />DtSCRtFu <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 />Signature oY A.plicant) (Date) <br />WHITE— Office CANARY — Customer PINK —File GOip— planner <br />3E "rd ',7)(1 IC':- 31±1IT <br />