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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N9 745 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />X Other 51 -tree\ a. t a.,1*ey Planned Unit Development <br />Va-/ca% /0 <br />Plan Review <br />Applicant But W'a r a F • S• � 5,, �e400 t S <br />(Name) (Address) (Phone) <br />Owner <br />Ct+Y <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />ia-- 3 "3 t- 3 °'2Z -33- 00 14 * ( 3o ZZ -33- °cos <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />b(P_ rMr -e <ctot a....e <br />r e(ol e <br />In signing this application, I hereby acknowledge that 1 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 receive. .m the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY — Customer PINK —File <br />Page 1 <br />/4-77 <br />pplicant) (Date) <br />o <br />