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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 />ohos <br />(Name) <br />(Name) <br />._..._.11af.6 <br />PAID 43373 <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />EUtt <br />(Ad wss) <br />e k-Xi e ( j <br />(Add ss) <br />Property Location (Street Address and Legal Description): <br />i4SD <br />60- 17/-70S <br />(Phone) <br />(4-81-1-;76g <br />(Phone) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />4b3 .D00 , S4 <br />Ia roOI oe <br />to T A) aces) tin. Ct) -b root -ry s -ct.i r Gott, 40 <br />5e o oK) 0 r/oor nr. 5.4-re-4), reQ son), its <br />w I I ND* ; ct& se C7r bedrooN -t. e <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing, and Subdivision Ordinances and current administrative procedures, I further acknowledge the fee explanation as outlined <br />n the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />NHI76 —C• fice CANARY— Cj>eomor PINK —File 001.0—PI nnm <br />SigOature Qf Appi = ant'), <br />„u 7 °:;Cd tiOVNV3 1711117 AII') <br />r t' P992. T99 <br />AMea -,)1 ..-003 <br />(Date) <br />9b:tt Er)))24. /K.,. /90 <br />