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Little Canada, Minnesota <br />APPLICATION FORM <br />"T° 83`/ <br />PAID `S3sO,OO <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 --Tit' <br />(Name) <br />PeCVC c 7 Z JCg-C C-Ct 61 (57-4/g3 sn( <br />(Address) (Phone) <br />Owner SC(M <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />FOr fr Alnl 0 /nSc6 J%c_ <br />res-i n-c the S!Pee+ . Fen (.2 <br />�or S4o�irn� <br />.crr LC, <br />flidr. rioph <br />her lit <br />Commit 4 oce l`' <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. l 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 />PAGE 1 <br />WHITE— Office CANARY — Customer PINK —File GC— ..- .... -. <br />ant) (Date) <br />