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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N? 924 <br />PAID 7e'- o-- <br />a <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />1 ` < <br />Applicant �\ \G\ i 1 r� ?> 2 Cr <br />(Name) <br />(Address) <br />(Phone) <br />Owner \,V � c CIF (�, � A1�(''�'P �C�( ($i - 9WC. / -. lft (3 <br />(Address) \ (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />7 6 (--, <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />9 <br />.1 signing this application, I hereby acknowledge have read and i y unde stand the applicable provisions of the Zon- <br />..lo and Subdivision Ordinances and current ad inistrative p edure.. 1 further dcknowledge the fee explanation as outlined <br />e application procedures and hereby agree t pay all state ems . • .. f om -th. City pertain) g plica- <br />on expense. <br />.F=f;. , l _� j,-) _ ,1 <br />(Signature of Applicant) - (Date) <br />HITE— Office CANARY— Customer PINK —File GOLD — Planner e:3%om <br />