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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 />(0,51.2S�e&sr e) <br />" v <br />cil AM I It <br />PAID L$7190 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />VSubdivision <br />Planned Unit Development <br />Plan Review <br />— <br />7.i —6Y/6J- <br />3 2 5'. S. 0 c.J.9 -rs j /vc i<osEvi% /cr/yl/l <br />esrn n--A: d'4fl . >r (37,520,4 4', ) <br />(Andress) (Phone) <br />0wnerdeo <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />.JAG •,"Y <br />) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />,�� /✓2 DW G <br />1th %/ K,e )4 keo ,/ idr c ,%;z _Tire <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ig and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />it application procedures a hereby e pay all statements received from the City.pertaining to additional applica- <br />4iL expense. <br />/HITE— Tice CANARY- <br />/ (Signature of Applicant) <br />tomer PINK —File GOLD — Planner <br />(Date) <br />-04 <br />