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Little Canada, Minnesota <br />APPLICATION FORM <br />Conditional Use Permir -.i <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />Owner <br />■ t) Q n rt-L,. <br />(Name) <br />, <br />(Name) .1 <br />Property Location (Street Address and Legal Description): <br />C- QS 4 0-c LL.:-4 R-c0 <br />A <br />?Al 0 <br />�f- <br />- • <br />Rec. No <br />Variance <br />Subdivision <br />Planned Unit Development <br />°Ian Review <br />(Address) <br />(Address) <br />Cirri (A„ /'(':i 1 <br />(Phone) 4�:.a-4;4-%L-r <br />c6t-rc.tAc <br />(Phone) <br />5 <br />escription and /or Reason for Request (Cite Ordinance Sections): <br />;y \j„,,„; A Y <br />c <br />%ol;`thnnb L <. <br />C:e 1) c? Prt.c _ St' {-,2 C'��� <br />d <br />ctna (`tk&s' 0k'r'SCf1C. <br />, 1 I <br />ht‘. <br />("Lc Lill <br />r'-2 Crec1 .10,E <br />/ii i 0 IA �O.Q - �.,,�i •7� . <br />\ 1 <br />t..;.Q i,C,rI c't, -1 l.'uLL' -*3 .O uu 4 i) t7 J2 C , I (,tC( 'l.CkL. -. L < I < C t. . Q.-.x ,s ii Oz. <br />�l <br />^`- . r1'Li Jt Li -I —`'� 1""— iVi "'1^(� I �' <.,� +— 1 "L "Z� �.' e_ C,�ri <br />I signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />g and Subdivision Ordinances and current administrative orocedures. I further acknowledge the fee explanation as outtinec <br />in the application procedures and hereby agree to pay ail statements received from the City pertaining to additional apoiica- <br />"on expense. — <br />Page 9 <br />HITE— Office CANARY — Customer PINK —%-lie GO LO— Fanner <br />cant) <br />(Date) <br />an _ <br />