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Little Canada, Minnesota <br />APPLICATION FORM <br />N? 543 <br />PAID 0.00 <br />Rec. No f1 <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant—T;.nc.crk,t B N\c, 'c-V( <br />(Name) <br />Owner Qaove < \. V.% \ t-ke■PbeNce <br />(Name) <br />u1� }�vo29 / -//7 i <br />2t51c \A F) ■s=a PY,0.0`< Me v <br />(Address) (Phone) <br />Property Location (Street Address and•Legal Description): <br />(Address) (Phone) <br />Rcm <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Pt-Fi, 1- \TCYar,s,cit \ )l IN Cx\P1; -(,\ N' i'-‘rCO \-\\F D00 % -\f-lS7 N\ Irt -i0LF LA \r <br />t--OT oFP- 14-ks PPQPF . Trtc L-oT W- MCA. \ \ , <br />MF. �/ \CW-C' ( l'Cn n \ �v,F -CiM P- .'h\\ -S- R `-50Nf\LF F=-f1hcM\\. -`/ 1-t1Mc 0" W <br />1 cST ib \t CV '- rnF<s rsCT V. atc, E �Px \\rte -- & eat \ pt k-''- n c`o<--",,K \--\( <br />212124"1 C"rn 7")a12I mare F3 <sr S VSF <ec-F.t.@>( <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 Qgniar a3as 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 />q <br />(Sig <br />WHITE- Office CANARY - Customer PINK -File GO LD-Planner <br />Applicant) <br />age 47 <br />(D'ate) <br />