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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 4 1/.�4aS f%� %C% A_/ (.N r'.>) <br />{Address) (Phone) <br />])11? 13.5 <br />(:) <br />PAID S° C,> <br />Conditional Use Permit 'S <br />Variance <br />_ Subdivision <br />______ Planned Unit Deve:opment <br />_. Plan Review <br />Own er AI. i...chaP,../Za;7i;C_,, „M <br />((Terra) <br />Property LoCa <br />(I.8c .332eit ._G 41/ 5 _.._.. <br />(Address) (Phone) <br />67O -gam}-, G'3.S"C> <br />on (Street Address and Legal Description): <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />M ._ riS _ //L <br />(-4S: <9.1n1 )7 _ v.,_ —.Cr' f.✓.SI.I' f .,A __J`a,, 67 e4 /i <br />/ 13t-- 5:7/9 .S.._ / /��v .Paz..[.... A_/%_ ? ill <br />/ S /cr _L,2Z_d7 yAC!) f <br />.�'� Ae Z / L<9;u!d.- 09_.. <br />C,e . <br />ec? f�XsIS- 7/1L_7i/C c_ <br />in signing this apolicaticn, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zor <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlines: <br />the application procedures and hereby agree to pay all statements received from the City pertaining to additiona. appiica• <br />1 <br />expense. <br />IM -1(TE- Office <br />(Signature of Awl? ' anti <br />CANAFY- : st na PINK —FI'a GOLD— P)anner <br />10'd 8£9bb0bl9g 'ON XU.d UUUNUO TI.I.111 (O .1.1;1 <br />/ ,(Date! <br />(17,71 f1N.l. ?fl- Rl -N,,4 <br />