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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 AOA <br />(Name) <br />N? 494 <br />PAID 61.00- <br />Rec. No .2-30(-00 <br />Conditional Use Permit <br />Variance <br />.--X.- Subdivision — <br />_._ Planned Unit Development <br />Plan Review <br />44 3C/C• C <br />�)/ <br />1n& 5 )-o ,l',). YoLew .ss-i vv <br />(Address) <br />Owner jaw ��i st e 3,49 Cr fi re, - <br />(Address) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />CITY OF <br />/ uTTtE CANADA <br />la+ "✓ sic:. "'C A✓ gar .-leJic <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. /esph <br />Z. l90- /��.r 'mew nnH es/ PMU»� e�A911 Csc /ic. /gay <br />yy ��sQ� Ore of Applicanp) / (Date) ,O <br />WHITE— Office CANARY— Customer PINK —File GOL�— fanner Pif er,°. -r.,r Page 14 n <br />