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Little Canada, Minnesota <br />APPLICATION FORM <br />° J.io2- <br />PAID C-3.51% <br />Rec. No <br />Comprehensive Plan Amendment <br />_ Cc.nditiona; Use Permit <br />Zoning District Amendment <br />Variance ".4, 3 S C.i <br />Text Amendment <br />Subdivision <br />Other <br />– — Planned Unit Development <br />- - - -._ <br />Plan Review <br />DGth Lo- Yet` ■ C'Llr <br />A mil can t OUr\\f‘0'M S/ <br />(Name) i GC) <br />(Address) (Phone) -- <br />Owner J <.jCj {o Tin <br />(N e) — �'h� 4_ C)�] c <br />�5Sa1. �ie5�c�e>;� (Hddress) <br />(Phone) <br />Property Location (Street Andress and Legal Descriptions: <br />613 I :It. t �d CE E 5' �f5 3 �Ti 1 Gr1 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />hrNir>Nz)L4- — Lk Uv;5\ AT, -1-1.e <br />DOA) its \ Cyrncebrt -- re' we.IL <br />S C 1 eJ11. <br />In signing this application, I hereby acknow edge that l have read snd fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances ana current administrative procedures. I further acknowledge the fee explanation as outlined <br />he app:ication procedures and hereby ag "ee to pay all statements received from the City pertaining TO additional a-ppiice. <br />expense, <br />illL . <br />nHire )tr,x Sign ature or A pJ1 (.$ it) `—GOLD—Planner <br />Cat_ -=� <br />es CANARY..,useomer 0NK_; IF, <br />111. .,1 ^ l Ol'9 :L )1;3 g9:CaT `faf�:,. T� 'll <br />