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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 />}e.T <br />(Name) <br />(t4 <br />(Name) <br />For L1'7=e <br />C0 le <br />SS(dAue, �5 <br />Plan Review <br />Gwr9"e_oV21' 6�is thcsS <br />a-P33 N' (4-67 vv(,Ke »-Ue <br />(Address) <br />x <br />,? 962 <br />PAID -)C <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development id?'ti. f.-/--E4 <br />25n-) <br />405e v r � <br />Sit :54 C57)as'-1701 <br />(Phone) <br />biome <br />150 7 64: --4-eN (.t1 s'{-c Cf <br />(Address) <br />r'roperty Location (Street Address and Legal Description): <br />6,51 6 36 -329' <br />(Phone) <br />ea( &si <br />6730 1 )3o <br />;2 6 (c9) Rice S +rc e± - C i /e CJ 0( <br />/ y J r� /n <br />i l �L UC F— ! r UVrf. Si' CO katt4 IV i'iY 1 v,41 <br />7 7 <br />i(1aV 527 Cee,„1 / i1 /) <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />g and Subdivision Ordinances and current administrative procedures. f further acknowledge the fey explanation as outlined <br />*' application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />do. xpense. <br />ilTE— Office CANARY -.Cu. ^.comer <br />{Signature of Applicant <br />PINK —File (3OLO— Planner <br />2-6 s1/4 <br />((Date) <br />