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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N? 486 <br />Rec. No <br />1i <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment X Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant P/ob,7L LiA) ✓7 /i E. Cb. let 6 MPI -ofb -2 2-JL/1/4-0 <br />(Name) (Address) (Phone) <br />Owner <br />fAM t <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />1, wtfr IA) L. (to /0 114 t(L "'rid a jr,Nr, <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />fiD9 V'i&0 I'll-RAMK 8onv) fIl tf 10 FT. <br />ilir <br />,,a-1.4t tit <br />A <br />SE'P fir_ <br />1989 V <br />t m CIT OF <br />c� cANApq <br />ALJ'o Ag1'3aValL 11 vki a oN wi v✓ldi&J f LLff P34»% <br />21 r. <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 />P.�, <br />(Signature of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD— PFhpv( e 2 2 m <br />