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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 />(Name) <br />( /me) <br />PAID _75 <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />,Subdivision <br />Planned Unit Development <br />Plan Review <br />i!•ea..aL WPM/ i . /.'.< /,l /.0 :.i 1 1 <br />• •_ • Ae• <br />(Address) <br />IA, /la <br />(Phone) <br />L <br />9 • <br />Property Location (Street Address and Legal Description): <br />Address) <br />\Joie edrif3R Cpt- ctiak as ,5q, 55U7 <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />r„ <br />I.... /.d.1.', <br />r,1 <br />. /'.f u. <br />YI. is <br />1 <br />I <br />I/ I, I/ ., .i . fit I it /Lel.: , .r .. Li .f• .1 <br />✓nps co , _ eaf O iPG (add g5AP\...,GhAt eh , < AP.kete <br />omit <br />In signing this applicatio , I hereby a nowledge that I have read and fully understand he applicable provisions of the Zon <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as o al <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional apf,,ca <br />expense. <br />ze/ <br />gnatre of Appli nt) <br />WHITE -0f fice CANARY— Cu.tomar PINK —FUo an%n_PL nnor <br />0 `22o- /<9— <br />(Date) <br />