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N9 749 <br />Little Canada, Minnesota PAID 4600 <br />APPLICATION FORM Rec. No <br />Comprehensive Plan Amendment X Conditional Use Permit45300 <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant PAAIG S Cefftwit5 /VC/ 1900 M 11M Or K•o. 440 c0-ft08 (6/6)234 -4,M <br />(Name) (Address) (Phone) <br />Owner <br />Stevie As A-re rrr cA-mr <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />3203 cot/Amity o/'rtF5t. 1,1 T77-6 e, v<ro ,- m h/ SS /! 7 <br />5& krmcti-t-o Fc's (- EG-,4-c' 055 a2 t P Tm-oM C&X H-us t r A-) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />GrTZi3e-AI c6A/ThR LAST Ancri7,'N t Nett/06S r-1/Y -1/y Petviocini/ (e <br />PnN lfousE) seirson e\-wi /N PWA-c6 � kivo A P&IU4stivENT <br />Wt-fire:PAIIVTh O 20 r H-16. rf 51r-rt. Tvtt F1241-44 (✓ ttio,(0--K ?Rom <br />wt -llff 4 Sit- n- vectoTH FA-OR-to wcc-c- &e 56kS c v,ci -wt Hv�VG. <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 adminis ative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pa all statem- is received from the City pertaining to additional applica- <br />tion expense. <br />WHITE — Office CANARY— Customer PINK —File GOLD —Pear <br />Page 1 <br />(Date) <br />