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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />PAID <br />N9 718 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant ak;. l'r \--CLIgRE- N G'l, } -1 ARK CA l. <br />l . <br />(Name) n (Address) y <br />Owner %! iJK�•4 I 1!}L(g &Ciu '? t? � h . l Lem ) (00.) PA WC- N. <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />LorS 19 hRL( )4 <br />'� o() \ ARK ST <br />oces ,5 , @Rn1 11 e.tGtti S <br />— 47C <br />(Phone) <br />ej$1 94[7(; <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />IC CC2C6i1/41rDi` LCE avtA. SELL t,ARI of iT �S <br />4 L `ELL: <br />ItLAR3LE <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 p ocedures. I furt • • cknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all s . ements receive• fr.m the City pertaining to additional applica- <br />tion expense. <br />WHITE — Office CANARY— Customer PINK —File GOLD- <br />cct C2 <br />Page 22 <br />E' / -3 (7: <br />(Date) <br />