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c <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Applicant <br />Other <br />&t y'OD o0 <br />(Name) <br />Owner C _-lAg-r <br />(Name) <br />Property Location (Street Address and Legal Description): <br />N° 810 <br />PAID 41-y/o oo <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />q)YD Q� Vn * e j1/6 (e/&_ p-e, <br />(Address) (Phone) <br />6f-z -7731 COO <br />7, D %Gviit,_ Zalce_r IV <br />(Address) (Phone) <br />-e eS Rat <br />Description and /or Reason for Request (Cite Ordinance Sections): <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 51 <br />WHITE— Office CANARY— Customer PINK —File GOLD— f <br />