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!ate <br />Little Canada, Minnesota PAID /J <br />APPLICATION FORM <br />Comprehensive Plan Amendment Conditional Use Permit <br />Rec. No <br />Zoning District Amendment <br />Text Amendment <br />Other _L t) /2 <br />Applicant <br />Owner <br />(Name) <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />�a �l � � - <br />a3 / ~�lG <br />AW <br />°(( dress) (Phone) <br />W A- — 61'5-1` (1/. /Ve) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />497A- 2 <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I furt er acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all sta r • eived f om the City pertaining to additional applica- <br />tion expense. <br />plicant) <br />WHITE— Office CANARY— Customer PINK —File GOLF— Planner <br />(Date) <br />0 <br />