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Ns? 899 <br />Little Canada, Minnesota PAID <br />APPLICATION FORM <br />Comprehensive Plan Amendment Conditional Use Permit <br />Rec. No <br />Applicant <br />Owner <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Cvsszc/ <br />(Name) <br />' /)-/ !_- /; Rd L .0 <br />(Address) <br />G C-/ -47/7/-0 a ?o <br />(Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />q.-/ 2z----// /2 z / //e y <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Q/'2 1 /a-Cy f/'^ �t ° •1 /dr O' d S .'17( <br />'n signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />e application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />nt,' expense. <br />Page 15 <br />NHITE — Office CANARY— Customer PINK —File GO <br />(Date) <br />a <br />