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Applicant <br />Owner ( i):SCP \,t r:4 Ale <br />(Name) <br />/® .26 <br />Little Canada, Minnesota PAID �c <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />rTh <br />Rec. No. <br />Conditional Use Permit <br />XVariance SCIO <br />Subdivision '>6 706 <br />Planned Unit Development <br />Plan Review <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />��C 7 4C),2FA:D E $, <br />t �JI <br />(Phone) <br />(Address) (Phone) <br />ipLi tt D ■V i 5 iCti Ne 4:& :7 c VT; <br />57 g '2n7 rr o4, 1a', F, <br />J1( 4 4 :3 <br />e— r9S 1,ci.13 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />ifl n'r.4fr i? J R n'4) /7 r` r <br />SO ' o y rte% <br />J io t .,yA ,q-ve 5 L K s b f Fg%, t1 R <br />l /mil ,i i ;9 Ne I" »M ire F 79 R rc7 sr? 0 p c R i rn L.7, i ;7 i i i <br />C.,C'E 11 C l OF KM r n/ / cry' 0 A/ E. co R f-rz P, R F X o -5 . <br />'n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />Ir • application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tiL.. expense. <br />(Signature of AoplicantI (Date) <br />VHITE- _Orrice CANARY— Ce4tOmcr PINK —File GOLD — Planner <br />:o 397d 1G *1Mt:n ?71.1 T7 ;. Tfl <br />R1,174hQCUi TCCI <br />