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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />j R u c CE 1-1- IK a r'-f <br />(Name) <br />KA-r'/4 3805. rues <br />(Name) <br />orc <br />Property Location (Street Address and Legal Description): <br />PAID <br />N? 505 <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />309 N R«c y &y-33aE <br />(Address) (Phone) <br />3o% N RI c,, /8 - 3357 <br />(Address) (Phone) <br />309(0 N WoobLYN'L <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />EO h/Sr'VCi-LO7.. o F /a 1qw F. u u=L <br />Si" 74. <br />PAS' <br />efrWidfiftkeedtiti <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. 1 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 />02 026 70 <br />(Signature of Applicant) (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLD — Planner Page 54 <br />`' to <br />