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,_, ~1 <br />~~ -1107 <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment $. <br />Other ~Gra1(;C-~'I p~GUh ~~1~ <br />Applicant ~1~,~7trQ,/1 ~ ~6 . ~~,~~1 ~'f26tA ~c~ f ~~ • <br />(Na e) (Address) <br />hwnar ~ ~~ `~w Li~(~u ~ P'l ~~ <br />PAID <br />Rec. No. <br />Conditional Use Permit ~~~ ~~ <br />Variance <br />Subdivision <br />..Planned Unit Development <br />Plan Review <br />.~S ~ ~2 <br />~S~ •~JS(.7'~~ <br />(Phone) <br />~5 t • ~"1 ~ = ~' ~j"f 2 <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />(Phone) <br /> <br />Description and/or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge <br />it fd Subdivision Ordinances and current admi <br />in ~~le application procedures and hereby agree tf <br />tion expense. <br />and fully understand the applicable provisions of the Zon- <br />~res. I further acknowledge the fee explanation as outlined <br />qtr received from the City pertaining to additional applica- <br /> <br />(Signature of Applicant) (Date) <br />WHITE-Office CANARY-Customer PINK-File GOLD-Planner ~~o <br />