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c <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N? 502 <br />7 <br />S O 'i <br />PA10a. <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment t Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Appl icantss' kinA- g-eocw9ta anr0 zYY //w 30/ba $ di V6 //lrols, /fl..(/m2yer /Se -moo <br />(Name) (Address) (Phone) <br />Owner Por i 4tc0 1 //// 3'eOA,1/4r. S, ' Ves ,,fly`s 104'rrfl/ -39e -jdoo <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />M.eeez S 24S-o .C'.z-CE Sr" � Jrrrcr <br />PAee5c r to .ercc - sr , .2,_2-rrzr eyrit ,29,,9� ,f14V <br />Sic .97rn•-a /a) ,K& Lis I trc et`" ✓ — E,rare..xr <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />$ irn.9egeo — .17A. Hraz--,,- <br />T#c' Sd5JG°CT $ c'z rY <br />o cAlewee- 9903/10 — PVGc.v £t$N46S <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, l 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 />(Signetl,Fe of Applicant) <br />WHITE —Office CANARY — Customer PINK —File GOLD— Phnr'p a e <br />i -zy -y� <br />(Date) <br />