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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />No <br />Comprehensive Plan Amendment / Conditional Use Permit .tSCC <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant &'c � V O ,Lys /Lit/ SE/ ,zvygLie W, 5.7- 44l/hd 6S7- ea 7 -/y Sc <br />(Name) (Address) <br />(Phone) <br />Dwner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />07 60 `/Cc. <br />(Address) (Phone) <br />P/4 /mss b74,79:2.2-,. -cog? <br />. 07- 4299.242- as -D0.2G <br />scription and /or Reason for Request (Cite Ordinance Sections): <br />�O 0,2z4eale Ci /'PN17LLZ.9 eciA <br />,Cu-r /,. ld4d CQit,v c h "404/; ,e4 <br />IS 6-foe. c <br />signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />• and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />on expense. <br />i <br />Page 28 <br />TE —Office CANARY— Customer PINK —File GOLD — Planner <br />L1/43/00 <br />(Date) <br />