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`.a I Li LG 11_HI`IHVH <br />Little Canada, Minnesota <br />APPLICATION FORM <br />— Comprehensive Plan Amendment <br />Zoning District Amendment Variance <br />PAGE fr73 <br />N° 947 <br />PAID <br />Rec. Na <br />Conditional Use Permit <br />Text Amendment Subdivision <br />Planned Unit Development <br />- ---- Other <br />Plan Review <br />Applicant R ok, ukse r .7-er- v CX t-J% v />7N J'5 L0,. Z <br />(Name) (Address) (Phone) <br />Owner n r° 1 iD t: v <br />(Name) (Address) <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />04 ( <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />ilrth )heelo nci, Platt\ t✓t)rn/ <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 />HIrs —ovr e Ignature of Applicant) <br />:ANAPIY— custorner PINK — Pile GOLp_Plannar <br />(Date) <br />