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Little Canada, Minnesota <br />APPLICATION FORM <br />? _an <br />PAID 4OE00 <br />Rec. No <br />Comprehensive Plan Amendment % Conditional Use Permit OS-00 <br />Zoning District Amendment Variance Ci <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />Owner <br />Precision Landscape & Tree, Inc. 50 S Owasso Blv(ft651) 484 -2726 <br />(Name) (Address) (Phone) <br />Lawrence (Mac) Groholski <br />7993 - 140th Street N (612) 685 -3406 <br />(Name) (Address) Hugo, MN 55038 (Phone) <br />Property Location (Street Address and Legal Description): <br />50 South Owasso Blvd E <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />see attached <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 />it He application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />a expense. <br />01 -26 -04 <br />(Signature of Applicant) (Date) <br />VHITE— Office CANARY — Customer PINK File GOLD— Planner <br />