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Little Canada, Minnesota <br />APPLICATION FORM <br />N9 541 <br />PAID <br />Rec. No <br />Comprehensive Plan Amendment X Conditional Use Permit <br />Zoning District Amendment X Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant <br />y69i -73 3/ <br />--�V✓y CCU -Y /'C- '3/0/ Courilyy /1r 24 W& GG- .,.��4 'SS��7 <br />(Name) (Address) // (Phone) <br />Owner " et.) <br />(Name) <br />(Address) (Phone) <br />Property Location (Street Address and'Legal Description): <br />Treec.T C — Liu.A /4r/ o », c -pGs si/G, f <br />d/ f4-4 yw 54.1 o/ 724 /VL, 5..<„,/uLn 6, /uwN SLi ry '-% /r4n,-G <br />� l 5 % C� 4,1/ :-7 G CA 71 S A 110 . ker• 0 /— Iy/ /uv <br />5T—er a G(/-a.S1 /y <br />4 0 /mot/ L,.. O F G ,.„.k7 4 r <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />s , 5„ <br />• <br />p* <br />gp 25 199° <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of tic <br />ing and Subdivision Ordinances and current administrative procedures. 1 further acknowledge tt fp» vyw Lin Wald ded <br />in the application procedures and hereby agree to pay all statements received from the City perWi tb'a Itional applica- <br />tion expense. <br />(turgp gppliar�t) <br />WHITE— Office CANARY — Customer PINK —File GOLD— P(�rner Ft'' 11 <br />(Date) <br />