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Applicant <br />Owner <br />Th 1 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />RlcLr L). TLorp <br />(Name) <br />_ n 771,.‘„? <br />(Name) <br />N° <br />PAID <br />O� <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />�7o Cos-f, 40- <br />(Address) <br />LP. <br />�o Cc-h <br />(Address) <br />Property Location (Street Address and Legal Description): <br />hit Cost Lone Cl..o-t- 1, - lock 2) <br />Conner <br />-2/321--.22/4/9 <br />(Phone) <br />/VW ay15 <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Cty <br />Gib -: st <br />;mom but <br />orri nOrCC ;s 0 ;coo-- Jo-& 1/4E2 <br />On corner /ot5 <br />mot) (k) 0k .sadj. sJ s ;t-s <br />re t r-I-or cci s la 5 under ; t , c7-3 <br />-3 <br />51\e c0 a' presont- <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 sta ements rece. ed from the City pertaining to additional applica- <br />tion expense. <br />WHITE — Office CANARY — Customer PINK —File GOLD- <br />o <br />Page 33 <br />5-A <br />(Date) <br />