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CITY OF <br />LITTLE CANADA, MINNESOTA <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Applicant <br />(Name) <br />Owner J -t <"- <br />-Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />CAE; 1..1.'9 6 I . �_ �,A,c, Dr 3 /S1'i-ti` -c? <br />(Address) ( (Phone) <br />(Name) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />111-6 { ' ; (=/ i)e <br />T <br />:t'\ l' 1 - -C `-,C'� °I:- <br />Y.. <br />Sc <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />1l. <br />(k TwtLi' Y� -.;�? <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 />3 d (Signature of Applicant) <br />(Please attach supportive documentation and plans) <br />q 3c- <br />Clerk's exhibit no. <br />Meeting- 2 -8 -78 <br />OOZE <br />