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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />— 06 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />VV Zoning District Amendment Variance <br />—A— Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />Owner <br />4 /Iec , ,t<.r •1, 1 .54,h' <; LLf. 9Q5- (cR. y Ar. 5v.( itit? <br />(hiame) (Address) L,t./-4. c +wn (4, lvl t SSi/7 (Phone) <br />(Name) <br />X73 G ✓( /q•i,�� [ <br />Property Location (Street Address and Legal Description): <br />LC /)5 r",- <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />In 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 />tion expense. <br />yyi <br />(Signet re of Applicant) <br />NHITE— Office CANARY — Customer PINK —File GOLD — Planner <br />(Date) <br />