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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 709 <br />PAID <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 %ti's ) _ AS (I g x � � Or)&-�- -- / b `De j Ik)oob <br />(Name) ( (Address) yy i) (Phone) <br />\\ // <br />Owner <br />65 3 <br />�to.2 <br />(Name) <br />Property Location (Street Address and Legal Description): <br />) tAtea- <br />B,ti Azieste, , <br />(Address) (Phone) <br />L a-P.. g1Q. aJ c ` r •r <br />(s_e_Jz, r /44 o-c 5-4neuz4R) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />PAID <br />JAN 3 0 1996 <br />CITY OF LITTLE CANADA <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 :II statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature Applicant <br />WHITE— Office CANARY — Customer PINK —File GOLD— Planner <br />/ Mae -96 — <br />Page 8 (Date) <br />