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Applicant <br />Owner a Th>1:2. as-red S.0.4.11etrS.Co fit✓ <br />(Name) (Address) <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />_ ue cts -rA c9 32°T S • 0 W.kl &Sa <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />1037 <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Oati-W20-. /1763 <br />(Phone) <br />SS/13 <br />i4OO <br />as.0 , ni KJ 437 75'0.5-253 <br />(Phone) <br />L <br />scription and /or Reason for Request (Cite Ordinance Sections): <br />QIU[E-1 —2—CdCp <br />i4 Co ). (20 <br />Ir iigning this application, I hereby acknowledge that I have ead and fully understand the applicable provisions of the Zon- <br />'n 'rid Subdivision Ordinances and current administrativ- ..cedur• I further ackno -dge the fee explanation as outlined <br />n application procedures and hereby agree to pay a eme.' eceived fro - y pertaining to ad Jition I applica- <br />:I f expense. <br />%gnature or Applicr) Date) <br />G• inner <br />Id TE— Office CANAHY— Customer PINK —File <br />