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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 773 <br />PAIDNtOO. <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 />Applicantt,,, C, ravc� 1 &riC ;`}f L <br />(Name) (Address) <br />Plan Review <br />o /7 .?4,5-3 <br />canctcal0. R , E 841 <br />(Phone) <br />Owner --SA w. (S C. 2retitit sac Lii$1,c conciilcw Rd, E, 4/83- 889 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />CV ; I l C CQ Aa do -eQ E. % Ike_ cet i,„tA x <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />S S i G cknAq LA..3 ENartic <br />C,i C 'GO A.A_ cv <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 />WHITE — Office CANARY — Customer PINK —File <br />(Signature o <br />0— Planner <br />Applicant) Page 20 <br />(Date) <br />