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Little Canada, Minnesota <br />APPLICATION FORM Rec. No <br />Comprehensive Plan Amendment /� Conditional Use Permit 5 00 <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Na 998 <br />PAID --t1,000 <br />Applicant Precision Landscape & Tree, Inc. 50 S Owasso B1vi651) 484 -2726 <br />(Name) <br />(Address) (Phone) <br />owner Lawrence 4,Mac ) Groholski 7993 — 140th Street N (612) 685 -3406 <br />(Name) (Address) Hugo, MN 55038 (Phone) <br />°roperty Location (Street Address and Legal Description): <br />50 South Owasso Blvd E <br />Jescription and /or Reason for Request (Cite Ordinance Sections): <br />see attached <br />1 signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ind Subdivision' Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />cne application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />on expense. <br />w <br />(Signature of Applicant) <br />WHITE— Office CANARY — Customer PINK —Pile GOLD — Planner <br />01 -26 -04 <br />(Date) <br />