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pplicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N.? 906 <br />PAID `5a <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 />N iAck C1k. -2, N h. /(S -OO <br />(Name) <br />� / (Address) (Phone) <br />lwner Ur )1 e � � /lee �� I i,� <br />- iL(D (� <br />(Name) J (Address) (Phone) <br />roperty Location (Street Address and Legal Description): <br />2cj 1 / .9 Or . .I�2- (4 I II i I(/p 1-0fi 1 ,JteC (`er %CIIS yf l5 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />) <br />%1tK2_J <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />' ^g and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />the application procedures and hereby agree to pay ail statements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY— Customer PINK —Pile <br />/ice <����/� ; G "27- &/ <br />PAGE 4 licant) (Date) <br />