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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant <br />Owner <br />PAID <br />N° 452 <br />Rec. No. <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />/4/ �X f� F y8 /- 9s7 <br />/�0� /�t, > y <br />(Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): �^ <br />%-/�E. l �/�'.� -'� r /t- %n, Cr1/45" // <br />(Address) (Phone) <br />/E'/ <br />Air 0.1.- zirr <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />/rte • ry,eea.,/; <br />ass-c2/0 - �. �i <br />et-24 it .from irr.iyc A c- ir> v C/a PVC , <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zi <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlil <br />in the application procedures and hereby agree to pay all statements received from the City pertaining to additional appli <br />tion expense. <br />(Sig ure of Applicant) <br />WHITE — Office CANARY— Customer PINK —Pile GOLD — Planner <br />Page 49 <br />(Date) <br />