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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant •3)4J If4k4)(/-0) <br />(Name) <br />Owner <br />DO kJ lethlv <br />(Name) <br />N4 828 <br />PAID a50 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />6700 &eRa ,l vet VIV, F. N1 yens FL <br />(Address) hone) 339 3/ <br />5/1- Zoe/d. 7 7 7 -2/ 70 S <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />,31 -7/ C5pRu .e SM. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />C % k 7' t/»1/ J7UP`4tf 9 <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 cedures. I furth acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all tements receive from the City pertaining to additional applica- <br />tion expense. / 4D/1 / <br />Page 55 6—a3-f9 <br />WHITE— Office CANARY— Customer PINK —File GOL6 Planner <br />(Date) <br />en@ <br />