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LI <br />Case No. <br />CITY OF <br />TLE CANADA, MINNESOTA <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Applicant /arc 74, <br />(Nam��//e) // <br />Owner ,OL /9, I' L.Drf <br />(Name) <br />//o d, <br />(Address) <br />(iii <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />(Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />ik,e5 /Q <br />Phone) <br />a <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />IsSio,) /rte GM)5 w cT An c te wit/ 7/2e/ int/ <br />In signing this application, I hereby acknowledge that I have read and fully understand the <br />applicable provisions of the Zoning and Subdivision Ordinances and current administrative. <br />procedures. I further acknowledge the fee explanation as outlined in the application <br />procedures and hereby agree to pay all statements received from the City pertaining to <br />additional application expense. <br />(Please attach supportive document, <br />;3 0 <br />7,z Ad <br />0zG <br />