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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 />h6„.„ <br />N° 568 <br />PAID Sd. <br />Rec. No <br />Conditional Use Permit <br />Variance <br />Subdivision <br />Planned Unit Development <br />Plan Review <br />(Name) <br />/-1-4 cAt <br />(Name) <br />(Address) <br />0Q-3 /V? <br />(Phone) <br />792 <br />Property Location (Street Address and Legal Description): <br />(Address) (Phone) <br />3•' 94" /e,at <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />,9 9. Gee <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 />� 72/ /99/ <br />igtature of App cant) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner Page 35 "`"^ <br />