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Little Canada, Minnesota <br />APPLICATION FORM <br />Comprehensive Plan Amendment <br />Zoning District Amendment <br />Text Amendment <br />Other <br />Applicant RI-N.. sT t\ VAiNv o4,\E- <br />(Name) ( -Nai\'') <br />N° 567 <br />PAI D <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />43 !_ <` c C n t� y y f P.e.ARv-f! 1���'• �f 2< l <br />(Address) (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />�--� AT \cczt f4q r\C14�.- <br />7 1 -97. " C�C> \ <br />E:x F. j \C\ F \ <br />(„t„, F C,F‘.1MPt \6 >ThI =L�� <br />\ ,c,s717 <br />CV"( : \ ' C <br />22_ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />2 F km EN, \Th• •r\Ltt =r \Lc= \ �C>. \\Q \\- <br />) <br />r <br />\L \= t --,.�cf \ c •�` 2 F \ 7 F \\ F \C' \t, • \ yc . <br />\••c-s FCC r \�\C,\vtz \ C \ yt --c-\ \F <br />�< =e \7Vptc• \ cTh ,•••• X74-\ <br />41= f" \C��l.� <br />t 1:AP -i CTS E s c <br />PAM <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 acknowledgeJe gx•..tion as outlined <br />in the application procedures and hereby agree to pay all statements received from the City pertaining t• .•ditional applica- <br />tion expense. <br />arc4f '- <br />,, %t << 9 / <br />(Signature of Applicant) (Date) <br />WHITE — Office CANARY— Customer PINK —File GOLD— Planner Page 16 <br />�.q, io <br />