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i <br />r <br />as <br />'olicant 11); <br />yii1 yr Li Ill.: UhNNUN <br />PRR NU, 5b14844538 P. 01 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />1:11)(,_ (Address) c>57/496 tiPhone) <br />PA I I) Kf C5 6.0 <br />Roo, No. - <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Sri ( <br />ner (4� ��_ ?- -�.� -f iL'Ll�l r"I /r i <br />(Name) <br />J. - perty Location (Street Address and Legal Description): <br />t.. le (.I /i11 <br />v. <br />(Address) <br />/,tom <br />(Phone) <br />(2.>scription and /or Reason for Request (Cite Ordinance Sections): <br />L <br />I signing this application, I hereby acknowledge that I have read and fully understand the applicab'e provisions of the Zon- <br />ing' Subdivision Ordinances and current administrative procedur s. I further acknowledge the fee explanation as outlined <br />in ti )plication procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />>n expense. <br />it <br />(Signature of Applicant) <br />A NI A a v_r..,,.n.npr PI NIC —File Go ix—Planner <br />(Date) <br />