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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 730 <br />PAID <br />No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />7< Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />/(Name)) �n Address) % (Phone) <br />Owner �/ 476 6v. 4 9,a, dress) <br />Ly4 e <br />(Phone) a /go <br />(Name) <br />Property Location (Street Address and Legal Description): <br />y0,0l�h,0 &iid, ; Spa,» 6 %zv,D ay /fie. G2a <br />/At 360. 7 f[ 074 ,U aa. <br />?/» - aL- a9- aa- aij- 0009 -� <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Re-- /yes, A 2sz'ka joc% 9/30a0 Ame,J <br />Atin,Wczi /6E- 7; 4/16flU 44n, er, 'Mrs <br />eZdrz &(/44// � ,64eC441 / 4 ,6E />t/..c4fie; <br />4 Ade/ ,ill dog /d t ov _ / <br />In signing this application, I hereby acknowledat I had read and f ly understa <br />9 9 p nd the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrativ .rocedures. urther acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay allA atement j- r -ived from the City pertaining to additional applica- <br />tion expense. <br />Page 1 <br />(Signature of Applicant) <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner <br />(D el <br />