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c <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N9 746 <br />PAID <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />X Architectural Review <br />Other Planned Unit Development <br />Plan Review <br />Applicant f/ct &S / fIiOLM the 2 tufifl/ foA0 J ' /,io ..it76 <br />(Name) (Address) VB'Hnsal- ikc (Phone) <br />` Z ✓ Z 5 C° �'rn`y � cif % `/3 Owner f/!r i=4/ <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />L-o1 / 7 6,11r7,-/ GeT, <br />Vifiv>/c OA-P-0- 56v77/ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />%D "04-• yb, ccA 57724/ 4-dr ,4 vvrr' op 71 /ky< f{&&'j <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 state, ants received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY — Customer PINK —File GOBI <br />7�. <br />Page 40 <br />(Date) <br />o <br />