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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />"`:' 960 <br />PAID ii'gC0,0c0 <br />Rec. No. <br />Conditional Use Permit AID <br />Variance DEC 16 2002 <br />Subdivision CITY OFUTTLPCAN. DA <br />Planned Unit Development <br />Plan Review <br />aplicant,-. \t 0C5C1C'.1C (-V- Oil- 1.i4Ocfji5 i taQ, .(Pt iz() ,LtdDE,) -LIS I.\14Pri..0 ck. 'Y k� <br />(Name) (Address) <br />`Jlfp{40Ly (Phone) NA, Ij S�tn <br />Los( - zss -•v 430 1 \4\Z-7)G3 -4414 <br />(v440 F,y «h C L;C) 0Q._ Su f 2 ( <br />4.-t QQ Asd�ss) i•i1�1 c"\-44 (Phone) <br />11tt q�'L- - lcait�S <br />C,vvnerG CCfl p t.*.11c (ZR(:}L.0 eiTi.. <br />(Name) <br />F Jperty Location (Street Address and Legal Description): <br />7 Ct e o a, Q ((St �'.� _ Lr - -i E CNK(A4` <br />I 0(-c, -2121 ' 22 -23 - 30 Le <br />)°°cription and /or Reason for Request (Cite Ordinance Sections): <br />icci�O c i CA 1? -1-n (A,2A- FCV1J t_ NU ' CAT. ivAc�e-k ji P\ r <br />U,S)DhOh, tkt tvs I AHa � Can a �. �a��� L1411 (' 1_ � 1,1olz�it ' <br />=iL C i Qt -istdr i Pf`tit 4,ckt (L1 I�iii7� 1?s.10 lilkSiK mrciikat; 36t"l''' <br />et Th E 1 -NAC 4A )CI-1 I-fl , <br />SrL�i_ v1 -4 -R,c) <br />L (.1\ <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />g nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />application procedures and hereby agree to pay all statements rece'ved from the City pertaining to additional applica- <br />)r pence. <br />11 i— Office CANARY— Customer <br />PINK —Pile <br />/(Signature of Applicant) (Date) <br />GOLD— Planner <br />