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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />N? 479 <br />PAID IL.IJ- <br />Rec. No 2-2- <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />/11,5 %r���e &A 17 Z3 4� <br />(Address) (Phone)Z /PS15' /7 <br />Owner <br />(Name) <br />Property Location (Street Address and-Legal Description): <br />(Address) <br />(Phone) <br />4QA_ 7,40)-- <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />St') Lt(XEnz <br />SFNA_ 311989 <br />cea <br />ore OF np. <br />InThecsuw <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 statements received from the City pertaining to additional applica- <br />tion expense. <br />WHITE— Office CANARY— Customer PINK —File <br />(Sign ure otol an�t)o <br />G Ctanne , yy <br />i <br />