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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 />m6" <br />(Name) <br />1ML <br />NC) 1023 <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review Co c yoS <br />n <br />(Address) <br />M, Ss-661 ^t 0 (1 c„ <br />(Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />7.5- 07/ 6 <br />r <br />(Address) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />(7: Ai 6- cioi /r ✓•'Key <br />ZEvc /6/,.•,e <br />/c ".'VF 7 /cJ_,...'/ <br />Am, 0 r / <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />^ /ILit <br />(Signatr,o Applicant) (Date) <br />WHITE— Office CANARY — Customer PINK —Ale GOLD — Planner ,/2 <br />