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Little Canada, Minnesota <br />APPLICATION FORM <br />N.n 960 <br />PAID -A D.00 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Concc.F 1- Planned Unit Development <br />rep e.l Plan Review <br />5310 L,'� eve /.� W,R.L. 55/10 <br />Applicant R0 CO (sorb RuI 18-Z.^i�S VIC, /�o _A 9q Ze-A . 4/ <br />(Name) (Address) SS++' (Phone) 763 -7j4 %502 <br />Owner <br />PUS <br />(Name) <br />Property Location (Street Address and Legal Description): <br />G k / t(Address) 0 6// <br />3Q So -rte; v. <br />Nom; kg-«r <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />CC N �t <br />ntep`§- re.viuJ 4- L03 subdf'v. R-r 20niaa� <br />ii ,• <br />COnczpf rtvlet,j 7- 1-0+ Su d>v: <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 />In the application procedures and hereby agree to pay all .tements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />/HITE— Office CANARY — Customer PINK —Pile GOLD- Planner <br />(Date) <br />