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CITY OF <br />LITTLE CANADA, M U\!NESOTA <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Applicant <br />Owner <br />(Name) <br />(Name) <br />A(i ,Jw JC <br />(Address) <br />(Address) <br />y Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />v- 5/5- 9$71 7( <br />(Phone) <br />,i<3y -7c S7 <br />r <br />Property Location (Street Address and Legal Description): <br />,_�.. 141; CNe -kYo 4 hi, 'TC/ �- <br />0 <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <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. 1 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 a' <br />, w,_- <br />(Sighature of Applicant) <br />9y <br />ooze <br />Clerk's exhibit no. <br />documentation and plans) Meeting- 2 -B -78 <br />