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Applicant <br />Owner <br />c <br />N9 7/9 <br />Little Canada, Minnesota PAID 3/06 ea <br />APPLICATION FORM Rec No <br />Comprehensive Plan Amendment X Conditional Use Permit yin <br />ES <br />Zoning District Amendment P : T Variance <br />Text Amendment Subdivision <br />J U N 3 196 <br />Other Planned Unit Development <br />CITY OF LITTLE C AY,InA Plan Review <br />LnAig 244 free 40„a 27r n.° nit( <br />(Name) (Address) (Phone) <br />rJo✓4J STnicti0,J .,,.. ri S Owysso 1f4'd Y4 -i %32 <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />S",3 S Dw4/so &Iv ), <br />5 T , fG -1 Ng t/7 <br />P/C 4SB See /Y inc(so Gl l -3<ior/ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />y03, loo <br />Gom.crrvc -r- c, S /. $J 1✓o. r Co. it 5 _JAAorri") <br />MC <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 GOLD -1 <br />(Signature o oolicant) (Date) <br />Page 62 <br />o <br />