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Little Canada, Minnesota <br />APPLICATION FORM <br />401 <br />PAID 3�0 <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 />17/62-7—:?/8._ <br />plicant I_ r, °Cn v; A ;'Z=; C cis. r 7�l 7 ��J.'C (• f - /36-'7 >7 <br />(Name) (Address) (Phone) <br />Owner ( /( / <br />(Name) (Address) (Phone) <br />P.,perty Location (Street Address and Legal Description): <br />72-1 n �. <br />O ;cription and /or Reason for Request (Cite Ordinance Sections): <br />tre <br />/ i`cir- 12n/� <br />7' <br />Q. <br />/ <br />r. /. 4 <br />/, El L <br />In signing this application ereoy adcnowiedge that I have read and fully understand the aopiicabte provisions or the Zan - <br />in and Subdivision Ordinances and current administrative procedures. l further acknowledge the fee explanation as outlines <br />in he application procedures and heresy agree to pay all statements received from the City pertaining to additionai applica- <br />tion expense. <br />'NI TE —offlrr CANAMY— Cuttamer PINK—Ale GOLC <br />Page 9 <br />(Cate) <br />