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Little Canada, Minnesota <br />APPLICATION FORM <br />337 <br />PAID %00.00 <br />Rec No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment >4 Subdivision <br />Other Planned Unit Development <br />Plan Review <br />M 1Cbfilt& <br />Applicant <br />act - ' ttM LC U(6 Int W. Keawaatle 171 - Z <br />(Name) (Address) (Phone) <br />Owner W ILL-I Ant le (al (G 2966, La.6n £ad 44fq -003 <br />(Phone) <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />a( l a ks f&Q d -- See : cc) Surat <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />u l s & t w e e r s 4 t , O r s ' rce/ Z efioni OE l a <br />gichit -io mtams, 9e4rifY &HP:. <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 />Page 64 <br />WHITE — Office CANARY — Customer PINK —File <br />(Date) <br />