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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />I ext Amendment <br />Other <br />Arc? 985 <br />PAID 0,3,-0 <br />Rec. No <br />Conditional Use Permit <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant .,l2 C ASS i �� I o2` /2 /`rf i7gie �rc/44( %(�i (&si)qfoS <br />(Name) (Address) (Phone) <br />S a <br />Owner <br />iitilfe G(y/r r <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />.�14/, �/ O§114..d4 M4 /7 - <br />Description and /or Reason for Request (Cite Ordinance Se(ctiioons): <br />CCP ?lC( /On.l'c,./ U'/O ?I (,r) (9/ CCc°SGr// Poi/7l�l <br />�7>1 /dlvT5 (.1-0 G /os-e / -7,A,8 La 14 rocfr eGirt9jy : oomac.J. <br />3 C,E Ai-Fa //, Lo cl!eJ <br />j vi fear <br />e frtet <br />In signing this applicationil herebVaCkn� ledge that I have and fully understarrd-tli Thppficable provisions of the Zon- <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />the application procedures and hereby agree to pay a all statements received from the City pertaining to additional applica- <br />rN r /0,i.er 'kat pr-DotcFiS d d[. <br />of Applicant) (Late%) <br />•re <br />1HITE— Office CANARY— Customer PINK —File GOt[S— Fanner <br />