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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 />N9 771 <br />PAID Oa0 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />MA -E% MAc4Ewg 1e j- oiltC The. in No &b kV, C. L� <br />(Name) (Address) <br />A3014& Oakes ] . a1 kio )% (LAr <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />2195 Pi4- Ri;•4 w�j — P14 -R; » PAR..k. TRRACE <br />i (kti ifriVA- 140 32uy <br />(Phone) <br />t 14/4 - Lin-3 ury <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Niel,., E or temp. 0PEkJ Nous8; M &ot/ +IoNE S;y,vs <br />1(z.— Z yeM. USE' <br />9- 41- c,c4-QJ ,vim t.rca d • <0 Q.aJ <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 procedur• further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statem- ' ed from the City pertaining to additional applica- <br />tion expense. � <br />WHITE — Office CANARY— Customer PINK —File <br />(S'.nature of • 1. <br />GOLD— Planner Pag <br />/a-27-77 <br />icant) (Date) <br />