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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N° 862 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment / Subdivision <br />Other Planned Unit Development f, <br />Plan Review L (a (1 IICiIp iL � <br />fI j �/ `--7 <br />Applicant (Cc%C IL; EI f1- 9- 1C(11- akl'e f ( 14 i ) (C(}S11151 )/(tS) (lat/IC -57, <br />(Name) (Address) (Phone) <br />Owner (A- —0 r ire e , <br />(Name) <br />La 0 A) z(i) ) <br />(Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />f �`� I�x �� L •I�i L I <br />In signing this application, I hereby acknowledge that I have rea 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 />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />\. / Ci 1 <br />Page 89 / / & -, /<'_) /CC' <br />WHITE — Office CANARY— Customer PINK —File GO.... <br />(Date) <br />