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Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N° 533 <br />PAID 30-0 .CD <br />Rec. No <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 />(Name) <br />Owner iv�t <br />(Name) <br />212.- Q gi <br />�y- 1/45-4/ <br />(Address) (Phone) <br />P )9o3 —/1, /y1LlVF9- 3r <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />AL -4.. , hAst M <br />at_ ao/4g04 /3- 4 » -3( <br />2 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />ea 1 0,9-4t qAttipit <br />PAID <br />'0 <br />0 /9 ', <br />CITY pJUIF .,.,,,J <br />LITTLE CpNADA <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 />g Q ct,ba, 7/3/P0 <br />(Signaturpcgd8pligut) (Da e) <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner etiDec) <br />