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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 <br />PAID <br />485 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Applicant <br />Owner <br />2,‘„SZczo. <br />(Name) <br />714(Xddress) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />Plan Review <br />" ggs <br />63 " -P3a7 <br />(Phone) <br />o . 6 ' f- <br />(Address) (Phone) <br />—7-----ncete_o_A-e-L /a-7 ra <br />(tc <br />Desc Lion and /or Reason for Request (Cite Ordinance Sections): <br />!) /ec aa&teL,7 <br />4 e /1 c4 r, Lc, <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 sta tij. nts received Ko e City pertaining to additional applica- <br />tion expense. <br />c- tS,a7S /99n <br />(S'.natur: of Applicant) (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLD— Plann&l age 4 1 ,v , <br />