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~-fi° '~' <br />Little Canada, Minnesota PAID ~.soo <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant G~ _ <br />~~~ ~/ (~Nam~e) <br />Owner ~[I IL vl~T I.~Cc <br />(Name) <br />4o iS~,~=e.e> ST. <br />Variance <br />Subdivision <br />~L Planned Unit Development <br />Plan Review <br />~6CC,~ r-i'~,.~ ,1n1~, ~Sl 4~'2 ~72~ <br />(Address ,r~.a~ ~~1~~ (Phone) <br />Property Location (Street Address and. Lega Description): <br />~7 <br /> <br />Description and/or Reason for Request. (Cite Ordinance Sections): <br />~~i1Js ~ <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />ino and Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />it ,application procedures and hereby agree to .pay all st ents received from the City pertaining to additional applica- <br />tion expense. <br />(Signatur f Applicant) ~ ( ate) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ~ C___,/ ,,,~j~~,~o <br />'9~S'U ~~~~es ~t2. ~/~wy.~L'.~.ss-r~J. <br />(Address) (Phone) ~~3~J <br />(~~~ ~3~8 gy9i <br />