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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Han Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />i 1 <br />Applicant �tst.,r,+t <br />(Name) <br />Owner "— 'e w\ u it <br />(Name) <br />N.cy 9 26 <br />PAID <br />Rec. No <br />Conditional Use Permit OC-) <br />Variance <br />Subdivision <br />% L&CA e - "Lb(' . Planned Unit Development <br />Plan Review <br />Property Location (Street Address and Legal Description): <br />0 E a cAev owl G 1: _LI L) e) I Q <br />(Phone) <br />(Address) <br />3 t o <br />(Address) <br />A 4\ <br />t' <br />5 "I �c • o•+.1 06-7- 2-.c 22 r ©Q4 <br />I- )V&, <br />(Phone) <br />iescription and /or Reason for Request (Cite Ordinance Sections): <br />k e_ /dam • <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i^ and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />ie application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />/-). 1 IP <br />(Date') <br />HITE— Office CANARY— Customer PINK —File GOLD — Planner ^e-C1'" <br />