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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />PAID <br />'" 893 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />/r )Subdivision (/ ic/ <br />(. Planned Unit Development ��% �, ✓. t <br />Plan Review <br />Applicant • F.7 cove. (4 PQI lE: Cry 1 - 76:6 - ,. ('I <br />(Name) (Address) (Phone) <br />Owner .."(---' �1 cst ttJ tC I <br />(Name) <br />Oc_42 7 -POc.7 - OE-LA-joy P to l; I - <br />- <br />Property Location (Street Address and Legal Description): <br />z <br />(Address) (Phone) <br />Lut,, 724 QQevfC <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />1 signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />1g 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 stat\amen' s receiv #d \from the City pertaining to additional applica- <br />tion expense. <br />Page 1 <br />IHITE— Office CANARY — Customer PINK —File GOLD—! <br />1' - <br />(Date) <br />