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Little Canada, Minnesota <br />APPLICATION FORM <br />0 903 <br />PAID-3.SQ <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant T ll.:14- R l `C' ..c. „\A /-9,92>F) EdC,,c7A-c\r 6 /.- 7 $ J ) <br />(Name) (Address) (Phone) <br />owner 7E+. �`f�l t'K()Il k Ed o-by. (c51 1 SL <br />(Name} (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />-, JF 5772c? Y SE .. Z,., H-\ C ,W- v,Yac 010(n <br />< n -k 75 C4 1\164\, 2 ‘5.111 // "at+ o'C'+ E \- 4ex <br />kzt sic-41.0y, `51 --1-awn4,tP a4 Rq. <br />scription and /or Reason for Request (Cite Ordinance Sections): <br />I signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />i „g 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 the City pertaining to additional applica- <br />t n expense. <br />V IITE— Office CANARY — Customer PINK —File <br />odaefa <br />(Sinnature of Applicant) <br />PAGE 13 <br />(Date) <br />