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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 6 /< <br />(Name) <br />t 0 <br />/\( <br />�C> <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Address) /e.,y..,:,r; <br />LcCiijj <br />(Phone) <br />76,0 ." <br />Owner <:'. J c �, s :,: � /O.*, �C tc f �� <br />(Address) (Phone) <br />—2c9 06 , -eeZCIC- 1Ef- /. Z , -,�30 <br />Property Location (Street Address and Legal Description): s��` ��w/ mfid b5/ S, <br />(Name) <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />1 signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />on expense. <br />nature of Ap.lIca t (Date) <br />.HITE -- Office CANARY — Customer PINK —File GELD— Planner <br />0 <br />