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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />fl P(6E. p( ) 1--& t4 T- C� <br />(Name) (Address) <br />N° 561 <br />PAID *WO' <br />Rec. No <br />Conditional Use Permit pAI <br />Variance <br />Subdivision <br />Planned Unit Develgyr�gf iiTTLE CANADA <br />lq►t <br />yin v <br />KR - <br />Plan Review <br />V (KING x-84 -275 -5 <br />1-o AV-t NW- 2312 PA kV. M PI,WD <br />(Name) (Address) <br />Property Location (Street Address and Legal Description): <br />bt3T Tel(SPCA <br />(Phone) <br />(Phone) <br />s,4-1 -lNE - 7 -6, Ul P?_t 'JE <br />(ca -Aci -4 +err) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />IsOci 4 U> 3CE a P 16 ` s r_, pa--1"1- IF <br />NORTH- f2rF , u Kt o COIN c. -r-c3 <br />o cA mss Pe LJ NL CO <br />&s(vAT b pJ -11-(E N J&R f-4 PRb <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. 1 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 />(Si <br />WHITE — Office CANARY — Customer PINK —File GOLD —Plan <br />ture of P apg ecar1tl <br />NiMid 9/ <br />(Date) <br />tee <br />