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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />Owner <br />717/7" <br />N`.' 993 <br />PAID 0 /, ?co <br />Rec. No • <br />Conditional Use Permit <br />�Variance <br />- Subdivision <br />Planned Unit Development <br />Plan Review <br />‘,/.2- 72o-/C // <br />(Address) (Phone) <br />(Name) (Address) <br />Property Location (Street Address and Leg Description): <br />c� <br />(Phone) <br />• <br />scription and /or Reason for Request (Cite Ordinance Sections): <br />1 igning this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outl Ili <br />th plication procedures and hereby agree to pay all statem ts"aived from the City pertaining to additional app, <br />c- sense. <br />4 -E— Office CANARY— Customer PINK —File GOLD— Planner <br />„„,,,i � / <br />(Pte) <br />(Signaturf- 2 -plicant) <br />