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Little Canada, Minnesota 89 9 457 <br />APPLICATION FORM <br />N? 457 <br />c 1). <br />PAID CC' <br />Rec. No ` «ice, <br />Comprehensive Plan Amendment conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant-11); C T f� o L, H rn. <br />(Name) <br />)wner Pe I W, AnJerSch <br />(Name) (Address) <br />C-e . Joao R. c e Si_ 4 tc - ,2 0 4- 7 <br />(Address) (Phone) <br />3020 (i; ce S <br />perty Location (Street Address and Legal Description): <br />Y-1 4 -ao4- 7 <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />3 ,yx5(,' (J -6; I ; €/ 5-6orvr, 5Ae)Cer /dd <br />0 cl) <br />CITY OF <br />LIME CANADA <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 further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />ro„UD . �.A ) ( <br />(Signature of Applicant) ` (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD— PIsplage 19 `e <br />