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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N? 31 <br />PAID ,67) <br />Rec. No <br />Comprehensive Plan Amendment t/ Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />a "es 9t G,.S a <br />(Name) <br />.5 A, <br />309/ f1,C-Pd/� 5/2eef 6S7— cL90— 9v72 <br />(Address) (Phone) <br />�S <br />40 <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />3 d q/ c., de St,eaf The 50V7Lti Sd 0,71 p f tic nC /A 361 <br />te. _....B 1 Lo A /3� ,Air f ✓ 5 .Sr, 6 olf ViSian <br />l t 4,4e-5 /di <br />4/ . 9-3 Ramsep C .✓r7`y <br />[ scription and /or Reason for Request (Cite Ordinance Sections): <br />A <br />5- ec or, o 0ez,ra ,' e <br />O „r <br />li signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ir and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in *' - application procedures and hereby agree to pay all statements received from -the City- pertaining "tmadditio'nal'applica - <br />ti^ xpense. <br />.- <br />Ilter( gnature of Applicant) <br />N TE— Office CANARY — Customer PINK —File GOLD — Planner <br />