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Little Canada, Minnesota <br />APPLICATION FORM <br />I`.' 900 <br />PAID <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment —A— Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant TS oMA-AJ A R &H <br />(Name) (Address) <br />Owner <br />r~ Cr Co ti-it/ A-13I-c 4 W-,q -j"ii <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />2 s k S f t:c_t <br />(Phone) <br />(6Q 4-2 6 029'7 <br />(Phone) <br />,C/ . 9,--al o070 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />( /4/rA ,--)G""c...∎ <br />(0 74- c <br />/0 • de ,, . ,47 S 7L5 << <br />j ; 4 C // <br />/f° <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />le application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />., expense. <br />NHITE— Office CANARY— Customer PINK — file, GC <br />Page 43 <br />(Date) <br />