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Little Canad I, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other1�+�rd <br />Applicant <br />(Name) <br />N 9966 <br />PAID ._2 /S1' <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision /-9.get.4 900 <br />Planned Unit Development 4100 <br />Plan Review <br />vies e(kc. is- 14 ce,St . suje, tot] ,psi - too `s ogce 1 <br />(Address) '�oSP�I (Le 113 (Phone) <br />SS <br />Owner SlJMe--- a's 0I7C- <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />Lo-I-- l , 31 cf� I , pay, Ic% PlacA— s-1 1�G '� °k c C°` u`— <br />>escription and /or Reason for Request (Cite Ordinance Sections): <br />signing this application, I hereby acknowledge that I have re <br />Ig and Subdivision Ordinances and current administrative <br />the application procedures and hereby agree to pay all <br />n expense. <br />HIT[- -(JFtI <br />d and fully understand the applicable provisions of the Zon- <br />s. I further acknowledge the fee explanation as outlined <br />y rtai ^q to additional applica- <br />(Signature o pplicant) - =d;.- iu I <br />CANARY — Customer PINK —File GOLD -- Planner /, <br />i/ <br />