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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID\P ADD <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant SC ivt,tvt5c Co Zoe liz/e CavfaGCCr <br />(Name) (Address)GrieCthad� (Pho4g±-2-2- <br />Owner SoPvl -t <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />2.777 conc0-7.1,-/ 7.4f3 / 73/ock 1) 445/ 11/-Qty- <br />Filet <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />ri(o; Lt;) c-F «Sr114 (-6" pavlcilfrtj S ace a/ot: oitiveuit <br />Dv) 171 / (L7 7r ti k((4 corfi?ecJS afr- l <br />/ nl <br />10T SG1iVed 13/ 203) 2/1 ZZ17) L, /a Ce2nZcic /a /eel <br />6gi(df -k)5 co“ e. <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 all statements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY— Customer PINK —File GOL <br />6' <br />(Signature of Applicant) (Dte) <br />Page 47 <br />