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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 />(Name) <br />Owner <br />N? 1040 <br />PAID - <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) (/ <br />c <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />2935 Country Drive <br />("f/2 r/73 <br />(Phone) <br />7-- 2? <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />PUD Permit to construct a new office building. <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisio- <br />.ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explr <br />in the application procedures and hereby agree to pay all state ,'t s received from the City pertaining' <br />ion expense. <br />(Sig ature of Applicant) <br />VHITE— Office CANARY — Customer PINK —File GOLD -- Planner <br />/ H <br />