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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 <br />Owner <br />PPM- ZN v stir, ;f– <br />(Name) ( ) <br />N9/� 794 <br />PAID L900. <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />q Ltil � :-� a P to <br />scary iOC <br />�; a (LE�J r �°n ivt) -,3 iie t.f iti(,v. Ssi'c <br />A dress (Phone) <br />Sa 6- <br />(Name) <br />(Address) <br />Property Location (Street Address and Legal Description): <br />4' a KM i 3 6 o �c /2 v,b�vr" ii 'tw�v Lc rc f3 (.ved <br />Legit L cd €sC4, t p iW ,4 Oct e <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />y�aes:1M -- Ai( riV ,L o-% fro pose <br />w; L ke rfNec <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 s tements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office <br />N 711/I <br />Page 16 <br />CANARY — Customer PINK —File GOLD- <br />/S5" <br />e) <br />O.@ <br />