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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />ha7 7 <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 />Plan Review <br />Applicant <br />1 Fila A5 , <br />SID LAdgpi~'ePd Pr, Yhkl, bAkeek c )2 -7y ( -3 oo9 <br />(Name) (Address) (Phone) <br />p (60 ) <br />Owner t { 0.CeT {nrr* e5 Ci.C, 13&E. CFyedC -, Cc,,4q 2s3-0732 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />PAP 0 �OZ6(Z2116017 , 5cc -coy, Cv Tow in 29 et,„ -e 2z <br />4UI -1-10? 5. ©\ias56 Blvd E. <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />ff lQi) cast, <br />�as4- -er 1 p f lay\ -Co f� � I ' . � t , 1202 + Ins �Q 4 +WCcd4) <br />0,4e <br />< 5h -rk q si' q± K S � <br />Ovve 55h &C,`.45 oc -14, a+ )( 10 <br />0,4e G ; ,�wh►� � - ;qc;„g 5t €f, qt 1) j o'' 5 <br />` k(v. 5' 54'5 Fa ct r., Sck+ , q+ <br />is 3 a vxd fwn q+ 3 t C,° rd,e s <br />In signing this application, 1 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 received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of A <br />Z5 / 2 <br />(bate) <br />WHITE — Office CANARY — Customer PINK —Pile GOLD — Planner enio <br />