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<br />Little Canada, Minnesota PAID` ~~ <br />APPLICATION FORM Rec. No. <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment ~- Subdivision ~ ~r~a <br />Other Planned Unit Development <br />Plan Review <br />.D~~r v A ~si~~~~-~~ ~i,~r,~Ecs~,~ z~ zo .s~~z ~r~t s~ ~.s-~- y~z -~.~~i <br />Applicant ~UKI"/L-y-1~f ~ )--l/~K1=LSGA~ .~.~)Z 5Pj~LIC't S! ~5"/ t}~C/ yS~~/ <br />(Name) ~ (Address) (Phone) <br />Owner <br />(Name) <br />(Address) <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />/r~ ~' <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~tatements receivedJf~rom the City pertaining to additional applica- <br />ti :xpense. / j /~~w~/'~*'~`" 7-~/l ~d 6 <br />(Signature of Applicant) (Date) <br />WHITE-Office CANAfl Y-Customer PINK-File GOLD-Planner ".'!~ <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />