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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant 0 Re0S <br />(Name) <br />/Y/o1- 1--1>' <br />(Name) <br />Iwner <br />N? 40'1 <br />PAID 7vO° —o <br />Rec No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />L .57-7 f S=N ‘37 Angel: e Tr u. nm -//? c 7 -_5 ` 7±E. <br />452 tir9CZe ee/cc/4 /T%L=t-: n /fPchot ne) (Address) <br />Ly To rc/ G Vj /HS ocee L./TTi.eG3?Ns/,A 4J <br />(Address) <br />°roperty Location (Street Address and Legal Description): <br />C ; VS awl 637 Li313&Re <br />ti <br />L d�: <br />2 <br />(Phone) <br />f Y'9 5y75 <br />/6q <br />*NS /0 h lcci< lj /v/cis R l5 C: <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />I C I No y t'-cii oio Af <br />,.<kid ai^y <br />vT t4.10 065 %N &o L•t■ C ES CA, <br />i ^1 /e'y 0 N7 1a{ ^:gyp (.75 c/ Cle5 C. to f' l(Un(s j /Ve4,.' <br />/0t // /v0). exist/ At 7 5r' fee- 6- iftt lr iCS i.l� e// c:i my /ot <br />(1,.0rr'IeV-'a <br />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 />in the application procedures and hereby agree to pay all statements received from ttte City pertaining to additional applica- <br />on expense. <br />vvHITE— Office CANARY — Customer ?INK —File np <br />GOLD- <br />Page 1 <br />anner <br />(Date) <br />