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Little Canada, Minnesota <br />APPLICATION FORM <br />'1 ii.rr .v.iib�a ,. <br />N° 482 <br />trt . cz) <br />PAID <br />Rec. No 2 2 70 1 <br />Comprehensive Plan Amendment Conditional Use Permit S V.)0 • 0c <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant __s-_( <br />(Name) <br />l ISAAPBEtA - i ail `tgz- — 19 70 <br />Owner l;rt.CGt,e,/ ,4 1 ,JEccrtE5 <br />(Name) <br />(Address) (Phone) <br />9 �AMP81tc I.8g co %ca_7cn/ 44,1-/9 7o <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />�eS J Eb3 E27-C ST. SC C- 5 %, ©w*n/ e9 nl1N(3 ( <br />SLA To STS 7 c S go r . of I✓ 01.9Yi1.yl F#. oP E c><Oc <br />FT, or w X <br />Z ofi <br />S6 c c TN �-9 RA/ ea, . <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />4 r RES • .I ecif <br />r <br />orz 51-11 r 4r <br />r3a�c_s <br />'1/4'11/0)-0, <br />-14, <br />1 <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. 1 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 />(Signatur - "of • pplicant) <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner <br />Page 13 <br />( at <br />61) <br />