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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 />er / C� A -e <br />(Name) (Address) <br />/ /JS Acct / <br />Owner �S�" / J7 • �1l� <br />(Name) (Address) c3�7(0 <br />Property Location (Street Address and Legal escription): <br />N? 944 <br />PAID 4c9, DO,OD <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />3e)o3 C ? 77 <br />70 743 a <br />(Phone) <br />76Y-50841€3 <br />(Phone) <br />Description and /or Reason for Request (cite Ordinance Sections): .. <br />In signing this application, I hereby acknowledge that I have read an• <br />ti Jxpense. <br />in ."-e application procedures and hereby agree to pay I sta <br />ing and Subdivision Ordinances and current administrative proced <br />)ne: <br />(annex cif Applicant) <br />NHITE— Office CANARY—Customer PINK —File GOLD— Planner <br />fully understand the applicable provisions of the Zon- <br />rther acknowledge the fee explanation as outlined <br />ecei ed from the City pertaining to additional applica- <br />(Date) <br />