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Vii° <br />Little Canada, Minnesota PAID <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />(Name) (Address) <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />88 <br />co <br />Owner �kZ� <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ng and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />n the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. — /4 <br />VHITE— Office; CANARY— Customer PINK —File GOU <br />Page 10 <br />(Date) <br />