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CITY OF <br />LITTLE CANADA, kiiINN =SOTA <br />APPLICATION FORM <br />Comprehensive Plan Amendment -Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Applicant <br />(Name) <br />Owner CjGCI��� <br />(Name) <br />(Address) <br />Planned Unit Development <br />L 3 67 <br />(Phone) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />�K \i\h U1J \U∎sr <br />o <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. 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 />29 <br />(Signature of Applicant) <br />St±, 2yCr, (c'ig) <br />oozG <br />Clerk's exhibit no. <br />(Please attach supportive documentation and plans) Meeting- 2 -8 -78 <br />