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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N? 875 <br />PAID `15-55-6 <br />Rec. No <br />Conditional Use Permit ..TO <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />,Lt �t, / <br />Applicant CL Ll1.Q ^Y1�w{ G�LkDi�C� ( 3 .�thore (2 t -i}4i� CctrYJa. )11 <br />(Name) u J (Address) (Phone) 2-{ -&4u.{~ <br />Owner .' )C1.i1 d \aU.v .t.r TL .6 \On. '14 3 Et.c 4- CaAA44,N, I.CI J o U4ii Ccur Q <br />(Name) <br />(Address) J (Phone) L{za -% 44 <br />Property Location (Street Address and Legal Description): <br />11-13 Cas -t CQu-.n f3 Rck i3 U Ca -nakt <br />I rac.4- A ct-nA SuurV -ut Me q I <br />Description and /or Reason for Request (Cite Ordinance Sections): C o <br />V .Q, (1...A caw r'-W\ rib OCW'aci2. `spa e -) h1C-P 00--e boa.4- 4, <br />v o.nk (*kJ/ ilk. v-sov a b-Ql 0e At )s, lkt knl-n <br />1t3.Q t3()LA, thu ko >)ut -C-U3 rcuc oft V S ate... (Lk Ise, a <br />c?�.c 6- �3-, r- (- .�u�-hu>< {.ak � r� Q as �p Wirt .s �c� 11- Ls c� n o � ,� Sr�rt c <br />In slgnit application I�h ereb%r acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing 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. d fin,1„ n LL-takz <br />Page 28 <br />WHITE — Office CANARY — Customer PINK —File GO LD—Planner <br />6 /4/oa <br />(Date) <br />