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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.ci.little- canada.mn.us <br />Deposit # 663 <br />Applicant's Name Address Phone # <br />,J61TY -e.vr 3'7 11.I(.,5 Cer,',s Lei- GOSSM .1 6. V0 'P I• (,< 616 0.2(,y <br />Owner's Name L 7 Address p Phone # <br />3r'.� Ic C.„1,r,.5be.('lr ! PD BOIL 5-76. 4ic, r`(,., Brc ;ntL)�9r1 6-s-05-6, <br />Property Location (street address and legahiescription, if known) <br />75` 0 1 ri r n-r,i Pc c <br />Description and/or Reason for Request (cite ordinance sections, if (mown): f <br />CI A, c C f`f f ?rP.V , J, 4--1 <br />Rur. <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 />administrative 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 />additional application expense. <br />.. tie-2C <br />ACTION REQUESTED (check all that apply) <br />Architectural Review <br />Concept Review <br />Co O <br />., <br />Conditional Use Permit <br />Final Plat <br />Planned Unit Development <br />Prelim Plat <br />Signature of Applicant, if ❑d P operty Owner <br />Subdivision <br />iJ - 7 J1 <br />'gnature o'- ' <br />v e2 .rt r, !L, .. <br />Text Amendment <br />� <br />i` 1 <br />\ <br />Valiance <br />Date <br />1 <br />7' <br />Zoning District Amendment <br />Other: <br />Total Deposit $ <br />`;c?U <br />„z+ <br />