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Little Canada, Minnesota <br />APPLICATION FORM <br />ITT° 542 <br />PAID c��C <br />Rec. No <br />Comprehensive Plan Amendment ii Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ANA'C77E C. P& TTy 3m CENTF2i/ as V - a s - a 5 j.3 - 9 /.20 <br />(Name) S% ,»a ddrms). V5 /�Se (Phone) <br />SA•72E — W /44 O& ,t1 Pl6PO/e-Ty fencW AF7E2 ?/. 2 7`90 <br />(Name) (Address) (Phone) <br />Owner <br />Property Location (Street Address and'Legal Description): <br />763 KELLE/L P4-2KA 4y <br />REG/S re,wz 4,5 7t/ D get VET/ NO <br />�41/ 7-4,9 C 47 .8 /szG' <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Pf, .m,ssa,✓ TD .6a «D 4- -r T,¢ Cl/Erb C4i24 GE mo "Wove DESC2 /, /-b <br />P2oP 7-7// &r%'icH #45 DernC...i) GA/LfI mac- ,g�/�E�vy. <br />r <br />PAID <br />In signing this application, I hereby acknowledge that 1 have read and fully understand the c }ysions of the Zon- <br />ing and Subdivision Ordinances and current administrative procedures. I further acknowledge the fed e5tj?tlsfiation 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. CITY OF LITTLE CA/{6/ <br />(Signature of Appi5a i 4 40 <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner �J <br />9 -25-70 <br />(Date) <br />