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(�IIY U► <br />LITTLE CANADA, <<MiINNESO IA <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning .District Amendment <br />Text Amendment <br />Applicant <br />Owner <br />DON GAGNE <br />(Name) <br />DON GAGNE <br />(ttlame) <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />2828 Condit 484 7S1'9_ <br />(Address) (Phone) <br />2828 Condit <br />(Address) <br />Property location (Street Address and Legal Description): <br />SEF ATTA_O MENT <br />U <br />484 7519 <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />SEE ATTACHMENT <br />• <br />0 <br />CiTY OF <br />TILE C,V I A r ; <br />In signing this application, I hereby acknowledge that I have rend and fully understand the <br />applicable provisions of the Zoning and Subdivision Ordinances and current administrative. <br />procedures. 1 further ackncwtedge 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 />ignature of :Cplicant) <br />(Please attach suji .... _ nentation and plans) <br />Clerk's exhibit no. <br />Meeting- 2 —B -78 <br />