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Little Canada, Minnesota <br />APPLICATION FORM <br />ITT° 839 <br />PAID -SO -.00 <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 />Plan Review <br />Applicant / 9 r c <br />(Name) <br />Owner ,c9/1/ <br />(Name) <br />eWjUC,: %7 TssJul 61 6S/ -T 3-s-5g( <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />< ; / <br />res-I o - Sip H- . Feir.e_ <br />T r gin ?PI obi fr c+ From <br />In signing this application, I hereby 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 />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />/? <br />PAGE 1 t Iy C �j <br />it) (Date) <br />i ana <br />