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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 785 <br />PAID-2c.A,e, <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 eV -eC 'Orl V� ��(��c-".'c\ COINS\ . ES21 83 Ave {Et-1- \-\( <br />(Name) (Address) 4/6 l/ (Phone) c7J <br />Owner RC \ (1�� �Q.h So 7 _ 62,P0 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />3003 Greerlbr \ C.Y— t_..; ) e Cur\caa , ati\- os -29 -22_.- (1-co9C <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 13 . `�iti —� <j` PcP <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner <br />(Date) <br />coo <br />