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Little Canada, Minnesota <br />APPLICATION FORM <br />N-? 886 <br />PAID <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 />Applicant /51.7-47/5' ) &/(_' /37O6• //wy 94, G4iie 5;m/take , /N/.l <br />(Name) (Address) <br />owner /7Omi-✓cf /2i2ZA <br />(Name) <br />/WC <br />Plan Review <br />Cri( 6 /2- 1•68 -341v/ <br />cfiJo C si - y 29- 3 9 3 <br />(Phone) <br />/ L 71 2/erce 8409nr ia.k S1- ?n ,4 vrw / s' at f- 207 r <br />(Address) 53774/ (Phone) <br />Property Location (Street Address and Legal Description): <br />)escription and /or Reason for Request (Cite Ordinance Sections): <br />A90 <br />C--4 f, f /1 --74 —. <br />✓ice (Co/ /./t!.. • f-/ ✓c <br />n 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 />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />ion expense. <br />VHITE —Office , CANARY— Customer ?INK —Rie GOLC <br />Page 45 <br />9/7 /-ZDO <br />(Date) <br />�„a <br />