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• <br />Little Canada, Minnesota <br />APPLICATION FORM <br />AT? 966 <br />PAID S,SG0 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant /4".n.A.-/s'^' <br />(Name) <br />Owner <br />Z. o/ /✓, ,j <br />(Name) <br />/OD 2- ',/2-3.< 4. a-., <br />(Address) <br />fie 4-4.o" !/S✓ca <br />(Address) <br />Property Location (Street Address and Legal Description): <br />Z s 2— V/ e /k-' ,A r)/ ,1,5 114 <br />N.' <br />frt. vir - rya Y <br />(Phone) <br />'S / -/Ft- /L/ <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />c -w <br />/0 a c c C. tC&,D_ <br />'n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ig and Subdivision Ordinances and current administrative procedures, I further acknowledge the fee explanation as outlined <br />le application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />t_. expense. <br />(Signature of Applicant) (Date) <br />IHITE— Office CANARY — Customer PINK —File GOLD — Planner <br />it <br />