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RECEIVED DEC 2 3 2002 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Han Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />;CI <br />Other COMei+ Planned Unit Development <br />X 15 lc rem i e 3 530 Plan Review <br />C 15 F u Udtr�s �c . �/62o 4 L9cif'Lane_ NE <br />(Name) (Address) 55+4q (Phone) 763 - 78+4245¢2 <br />Applicant <br />C vner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />3Q 5o Tw?•v\ LcLkc- Rc� . <br />(Address) (Phone) <br />It <br />tiewz /17/ri» -( <br />Co c 1, <br />D ;cription and /or Reason for Request (Cite Ordinance Sections): r N <br />L n nOtir\- .A rev; tAJ <br />4- LoJ- Subd,'v. R- ton <br />is v.. <br />CoKCCPI . rcvleAti 7- L0* 5 b d; <br />r igning this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />n� nd Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />n application procedures and hereby agree to pay all tements received from the City pertaining to additional applica- <br />il expense. <br />(Signature of Applicant) <br />V!„ r E— Office CANARY— Customer PINK —File GOLD— Planner <br />/a -a3 -OZ <br />(Date) <br />