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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text An- endment <br />..... Other <br />F iplicant <br />t veer <br />N? 9c7I <br />PAID _'*'0_. <br />Rec. <br />___ Conditional Use Permit <br />_._ Variance <br />Subdivision <br />Panned Unit Development <br />Plan Review <br />tperty Location (Street Address and Legal Description), <br />'1.3.3.9.4 IT ,ti e. r__ 4L <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />_.rte. _ v . 'rte <br />av <br />oicce4Lie <br />igning this application, I hereby acknowledge that i have read and fully understand the applicable provisions of the Zon <br />d Subdivision Ordinances and current administrative procedures. I further acknowledge the foe explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t n expense. <br />(Signature at Applicant) <br />WHI $ E- OtSa <br />CAN AeY-- C.,stomur PINK —Elie, GOLD - Flamm. <br />1/q <br />3 "L <br />) ate <br />