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1 Th <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N9 <br />PAID() <br />7j <br />Rec. No. <br />Comprehensive Plan Amendment / Conditional Use Permit <br />Zoning District Amendment vv--- <br />Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />Owner <br />RICLri C orp At7O Cot LVl <br />(Name) (Address) <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />ADO Cost Lone (LL- <br />Corner 10+ <br />(Phone) <br />/VW aye <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />C; b' L( Q (c nOr c€ <br />C -b toclh+s <br />alp (.-_. <br />butAi <br />i <br />s i -Poore,- iot /;ale on Corner /ots <br />moved ` ek set f) 6 ;t-S <br />ne;n -corcei Slab unjea- (-t% C; /- <br />r She ' re en* OCGIllon <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 recie. ed from the City pertaining to additional applica- <br />tion expense. <br />Arlisrafri <br />(Signature of Appli % {t) <br />WHITE — Office CANARY— Customer PINK —Pile GOLD — Planner <br />Page 24 <br />(Date) <br />