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Little Canada, Minnesota <br />APPLICATION FORM 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 />N9 78 <br />PAID ‘.";?.-3-5-6 <br />Applicant (271//gel ES () m7756 c9 9evEo et Td 4) 'A`h467 <br />��^^ (Name) (Address) (Phone) <br />f9-InE <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />Owner <br />E D & r -s/ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />V i4.✓ r 7tur m60:: (2 4946 - n/ faar °x <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 />/ / 71 J -/g / U <br />Page 29 int) (Date) <br />WHITE — Office CANARY— Customer PINK —File <br />