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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant ► /-K_ / I5 ( g(V <br />(Name) <br />Owner �\ <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />// <br />N9 799 <br />PAID IS7Co <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />) O it' - kb —De <br />,,()fLODOO <br />(Address) y pV (Phone) <br />(Phone) <br />5.E <br />1 (0.2 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />rtful <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 <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner <br />Applicant 1 <br />ge <br />/ -3\0 -TC? <br />(Date) <br />,ai Lo <br />