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Little Canada, Minnesota PAID (1)S7)6, KZ) <br />APPLICATION FORM <br />Comprehensive Plan Amendment. Conditional Use Permit <br />Rec. No. <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other <br />ApplicanT- Q O S FO E N <br />(Name) <br />Owner C5A 6�t <br />Planned Unit Development <br />Plan Review 6+ r,S1•55Lf ^ ?no <br />c 5i-C3-8a4'( 0 <br />I V?F \N s',prim/e <br />(Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />1-1 i?7 VIt' t <br />(Address) <br />(Phone) <br />I� .t L, (.TT L . C 1. /k 4 Y N <br />.551 1 7 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />N t = E p PER : 5 & N A L , 5" o R A& (N ti' i {:= o E = - Z C O m U. E R- <br />CIAL u_5 � it� S ( r C� E1 56� • (�t • of: :\ <br />6K MY PR(..) y o O O I N A M C E R. R.AL,/ <br />Ilno./0 ,;pme/2)1: PEMloR ANNC. RE.Qu(RREg1 <br />�3/ C <br />/3 /x C2% i '103, 0 ab 6 1D, P . V P\ A <br />I n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all state e•nts rece'Oed from the City pertaining to additional applica- <br />tion expense. <br />Iq APRkL ?o <br />nature of Applicant) (Date) <br />WHITE — Office CANARY— Customer PINK —File GOLD —PI: • ner <br />