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Little Canada, Minnesota <br />APPLICATION FORM <br />'ti? 8 8 C. <br />PAID - 7fr;.e0 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance -7 <br />Text Amendment Subdivision Y /�� /GO <br />Other Planned Unit Development <br />,ppiicant A ,i;2• • i.• t.V <br />(Name) <br />Jwner <br />Plan Review <br />Q 2`3 Goo iz.-4 X12, It <br />&.71(c- G °Ca t, t i j c.= Ca 51 I— ?te> -x(•07 C <br />(Address) (Phone) <br />A7Ca9 —C94/6 <br />(Name) <br />roperty Location (Street Address and Legal Description): <br />7St <br />(Address) (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 />Ig and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outtinec <br />1 the application procedures and hereby agree to pay ail state n_egtsrreceived from the City pertaining to additional applica- <br />tion expense. <br />"'RITE —Offlat CANARY — Customer PINK —tile GC. <br />Page 27 <br />.2 p'-<i <br />/Date) <br />r <br />