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Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />i <br />a reo <br />(Name) <br />N9 7a/ <br />PAID <br />Rec No <br />Conditional Use Permit '..-2c7S° <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />a 70 70e711(nevidy tSt. <br />(Address) <br />Owner ilelreit) C' .f &av7icl J, 'View) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />a�70 MC'/l%47Nir7 <br />(Address) <br />a 570 11Y7c i/lenr'rY y 51, /fed; <br />ncP ,S a,rue/ <br />Prepe.rf y IP tic./ pv,u OF c2), 00/3 <br />33/j <br />472 -/ ?/ <br />(Phone) <br />',902 — /S9% <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />/fez Le <br />Peiae l h2'.776., occ.Gtpa><i6), fie vial f <br />ordinance 903. / 6) £,. 02.7 a. <br />Ot ci nelyll borJzadcl /eenager <br />W'e ✓' t 1 J <br />�,�c��S��MS a— the F41 r <br />7'o al /O 4 <br />in /Der /De Ad vm <br />aS requires( b7 <br />j7a /- /-role ern p/o yMw77 t <br />Cteiricctl 7C�' <br />S' ieS <br />Eebev Sizti-idcrvds (- <br />l <br />/v1 aacerd'oncc- <br />1te`,ev u' 'tit de fa (s re: (104 -tire o honte OCct- cfet1--vchi /7lav7rled ernDleynnel1 <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. 1 further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />/-c_) 7.e S/30/q6 <br />(Signature of Applicaryty (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD —Pla <br />Page 13 <br />