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N.? 983 <br />Little Canada, Minnesota PAID f r�eU <br />APPLICATION FORM 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 />,4too7zeAf/J9 / q O +4k -69/67 <br />Applicanta-S,PV&, Arlo ete:+l't�:t L c)( R,(e Zi #Ze .v4-,u,4Ji%al 6o5/-'/ 7.at <br />(Name) (Address) (Phone) <br />Owner <br />& /ck V ir1v <br />(Name) <br />27/ Jvy Avc t3- Si r/ Adi.) 5-Q/7 /* 7 -/73 <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />027o' R /cC (6 69/1/4-449 Mti <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />10 44-71- R ✓3 13P_Lryn CiOLee et, * Zoc•Acn, <br />o Pei e, , 4 de; f /tee Ciatc, ce-cn„ , # .7) e% <br />WC.0 'V• ∎rv," 44121 AtsICA241U4.Q Altetilde,,,asra 7:(3) WO 0r /e N/k ,S/oeggc <br />n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />,ng and Subdivision Ordinances and current administrative procedures, I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ion expense. <br />7f} %s <br />(Signature of Applicant) (Date) <br />VHITE— Office CANARY— Customer PINK File GOLD — Planner <br />