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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N° 528 <br />PAID J d-n <br />Rec No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />Applicant 77164/14-S GU STEW54r 0/0 ?-7 cMKtvecL Pk /AV 7Sb 8t /y9 <br />(Name) (Address) (Phone) <br />Owner Pitt- 5iL,L08,-% gig £oSE LAcrE 1/16.) - l9� <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />j , _I , ? £ccs Lt E <br />fOCC4 P K, )_cT I� BCcC_k / <br />ran <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />catM <br />CO ACCESS 10 Eos �2 f 2,07' <br />gg-O U6ST £,9--s,r'hE/Ur S&V77 WeS % Orr O <br />S' VA-&E- Li s& . <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 adminjstrative procedures. I further acknowledge the fee explanation as outlined <br />in the application procedures and hereby agree to p. _:,rs;FS :utT"t�k4tig lTaicno�,e_ ty p taining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />WHITE — Office CANARY — Customer PINK —File GOLD — Planner Page 52 <br />( � <br />SAO <br />ate) <br />