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N° 458 <br />Little Canada, Minnesota PAID Co Cc <br />APPLICATION FORM Rec. No 2t5a—% <br />89 -10 <br />Comprehensive Plan Amendment Conditional Use Permit WIC( <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant ( -/y`C fir/474'W <br />(Name) <br />/5 /r6v. /iti' f 772 -2CF--C <br />(Address) (Phone) P.5 /CC <br />Owner 60'12t'�. I �' GJ�9�f✓'.t/ Srf/ L /r77C Ce,gm..s rl..v ' <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />/ g -e- f L /%'f -1 �1 iflf t/�J�i✓ 7 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />MAR 061989 <br />GIIYOt- <br />UTTLE CANADA <br />In signing this application, I hereby acknowledge that I have read and fully understand the applicable provisions of the Zon- <br />in Id Subdivision Ordinances and current administrative procedures. I further acknowledge the fee explanation as outlined <br />in ., application procedures and hereby agree to pay all statements received from the City pertaining to additional applica- <br />tion expense. <br />5/� <br />"'Signature of Appticant) <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner Page 39 <br />(Date) <br />�j m <br />