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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />Rec. N o. ___ <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />L'/ Other Planned Unit Development <br />Plan Review <br />4,iz- Qq3 33�f <br />,Applicant27,41/si0-41, /,(/c. 357,51). G we72,4 9urT$ Z7o — 4/IAeu /4u s 65V -1,D- °6°!40 <br />(Name) (Address) (Phone) <br />Owner 54.1 <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />.gtE 7Z2D ? 3ZZZ.. 4t ca Sn e r <br />LETS l¢ /5 ArU1cx. / / B/ aeAJ 61.64)cc,i9tf2JG <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />LOT C0.P5o4414-170A) of 2 cm/T/fivous ,Ogi.c cs <br />' - signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions or the Lon- <br />g and Subdivision Ordinances and current administrative procedures.1 further acknowledge the fee explanation as outlines <br />in the application procedures and hereby agree to pay ail statements received from the City pertaining to additional apdiica- <br />cion expense. <br />41TE— Office C,ZNAAY— Customer ?INK —, Ie 30 LO —Planner <br />