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Little Canada, Minnesota 89.19 <br />APPLICATION FORM <br />Comprehensive Plan Amendment ^ Conditional Use Permit <br />N? 467 <br />PAIDC:e7 (24 11 <br />Rec. No t'O'/ <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant _Le cI eSnh I/30 Noises ocbKIVC' <br />(Name) <br />(Address)S40 ?CV Icl.✓ ff /26 <br />Owner Xri'V 710 q %`/0 l4-4 eh brlve <br />/(Name) (Address) EQya <br />Property Location (Street Address and Legal Description): <br />7S .SO u l on+ Owa SJ D Q've Litt <br />,±es -d- GcoK S'3- GO6009'6 -3e <br />77 / -f-// Gtl <br />y8,-ems /y <br />(Phone) <br />93S 2/94 -4) <br />otd^ - 6 6149 H <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />See H I /C6t-e6( <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. a g e 29 <br />�vne 11 /t <br />gnature of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —Filb1 GOLD Planner <br />