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Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N° 507 <br />PAID .;U <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 />Plan Review <br />GIRL D. cc c,- lies T #9cc.3 / 9 2 / 3 <br />(Name) (Address) ,Ii 2 Gt� /�tn ,(Phi e) <br />Owner rSct�f�— <br />(Name) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />/�;� io r 0 cry gel c cf/b.f /9)J17/v <br />(P/t!_S )A/ c i,., Jr -7 L-/ L 2/C <br />SSW 2 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />fL3 13`34 <br />CITY, Oki -ln�-� e N? <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. <br />f` lC J ,74 r7/7 <br />(Signature of Applicant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD— Planner rage 23 <br />