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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicantfe -k <br />(Name) <br />Owner ban∎ 2' d, W <br />(Name) <br />X <br />N? 878 <br />PAID <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />-cakenf{ a3 Z Ztbcrp fed 2-,Lki2 4fa 40.2 <br />(Address) (Phone) <br />cri,nAt r/4s e Cpm-Li d 6a 1,AQ(Grcai.cc. q? - g <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />1143 C Cowl 6 P,a. , <br />lard SLuA), Nb. 49 <br />►4 6V r-eS i eS <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />corns -i- o , a_ dLe- --c-c �. ec O.voc y <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 />tion expense. <br />.1 <br />NHITE— Office CANARY — Customer PINK —File GOLL <br />Page 35 ��.2 (Date) <br />,ekti 77-4 :CIO <br />7 /,>2A /Cc' <br />