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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 <br />Owner <br />PAID <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Cot) 5ct,(_rn 75/Lt/,32f ,XNC. '/ o glee ST2&ei 651. Lk15. /110 <br />(Name) (Address) (Phone) <br />/Y ICOMEL /2. nl ELLC/ <br />(Name) <br />5 ksv 5u4 /2/:)-E- Die /flPt5 <br />Property Location (Street Address and Legal Description): <br />(Address) <br />(lc o (21c 2EcT LITTLE 67RIA I) IY1kl S5))3 <br />(Phone) <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />940 (N .ALE- P? > r bl evyuc2 /EGAD E <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />,nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />11. a application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />on expense. <br />(Signature of Applicant) <br />2.2 -65/ <br />(Date) <br />'HITE— Office CANARY — Customer PINK —File GOLD — Planner • -iio1 <br />