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CITY OF <br />LITTLE CANADA, MINNESOTA <br />APPLICATION FORM O�O 3c °� <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Applicant / l o Ls- <br />(No rne) <br />Own er <br />e;ct of -99,57 <br />-Conditional Use Permit <br />Variance <br />XSubaivision <br />Planned Unit Development <br />Lsfr-/,5z= -/ IV. /�(,;c //Mr-.) -Mu /% <br />(Address) <br />yy sip <br />(Phone) <br />(Norge) <br />(Address) (Phone) <br />Property Location (Street Address and Leoal Description): <br />/lbw: fric- 2 gel C 1-/v /t 31 <br />J <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />/616;2_57 /7/97- <br />! f, %F/V ./2/9' % /ca./ - 7,v,<'�l%i 3" <br />In signing this application, I hereby acknowledge that 1 hove 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 />ooiitional application expense. <br />8 Signature of Ap tiaa , -0O2G <br />Clerk's exhibit no. l� <br />(Please a" documentation and plans) <br />Meeting- 2 -8 -78 <br />