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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N9 759 <br />PAID 700 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant 1:5 4-(1 / (Jni 77 Ue 7 (4) tl/cogo y/V /V 4/V.13 <br />(Name) (AAddrress) 077°6 <br />(Phone) <br />Owner �Le/ OP/ � 5 7�? �i <br />a,1fVa /�/ <br />(Phone) <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />tor- / ` 9.72 2,7 eD 2, 7 <br />Chi x--06 9 -77a i•5' 6� <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />,/lam /(v9i/1/2s-- <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 furt• -r : cknowledge the fee explanation aotlined <br />in the application procedures and hereby agree to pay all statements r ei d om the City pertaining to additional applica- <br />tion expense. <br />Page 1 <br />WHITE— Office CANARY— Customer PINK —File <br />(S'gnture of • <br />GOLD — Planner <br />7 <br />plicant (Date) <br />