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? 938 <br />Little Canada, Minnesota PAID SZr `' <br />APPLICATION FORM Rec. No <br />Comprehensive Plan Amendment / \ Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />Z. <br />(Name) <br />(Address) (Phone) <br />Owner � j <Q f ovt,i6'5 P0/4 Fuf -cf_X :59-1 L C I F LS (: niv si 04 f<" l f <n 3 . -Cl 9 i <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />3s5 olio gpv1 <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />Z` }�tS N. 'BLOC <br />- <br />• D (525 /1)07 Co>n1 F 0014 <br />N I: <br />COj)C5, 1.-300 Tlo1\-% w )L-L. ✓>' )• CF;L 3)S csR 3OJO <br />(-)-} 1 iu O N (O N Fo' t t ,0 P v 1 V 1' d i = 1) 00 t L O/ 6 <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />..ig 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 />(Signatuhe of Applican/) <br />HITE— Office CANARY — Customer PINK —File GOLD — Planner <br />5 0 ; <br />(Date) <br />