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Little Canada, Minnesota <br />APPLICATION FORM <br />N? 1034 <br />PAIDSC% <br />Rec. No <br />Comprehensive Plan Amendment f ` Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />applicant (arm'.y j' neS Pctc)jegS4. 2-71. Lct6 5hove f1'Ija (051- 330 - 1-(370 <br />(Name) <br />Owner <br />C n m y•- J Cw4 es <br />(Name) <br />(Address) (Phone) <br />PV1 egsg 5110/e tkire 6,SI- 33rD. -L/3 "7 <br />(Address) (Phone) <br />rroperty Location (Street Address and Legal Description): <br />2-7 Lcckz Share psc <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />C/On GO t -i"'I pia} tioLia P-er al 4- <br />< - 0 ■R,r s tzny, CiCzrcoc -e. <br />c_ 6 x 4z,c <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i 3 and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />it be application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ex pe n se. <br />? in cl'taLei to /s /U`l <br />(Signature o pplicant) (Date) <br />IITE— Office CANARY — Customer PINK —File GOLD — Planner <br />