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Applicant <br />Owner <br />c c. <br />Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N9 576 <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment <br />/Subdivision Subdivision '$ OO <br />Other Planned Unit Development <br />Plan Review <br />)04N + CAR-01- ,8Rfilu,5cr3 02337 eCAYTO2viq.C- 51153 -5 y05! <br />(Name) (Address) (Phone) <br />(Name) <br />Property Location (Street Address and Legal Description): <br />L)75 E. /4N&- <J u€ <br />(Address) (Phone) <br />Loy Be- /ti b <br />�v N °C 1-I-1 <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />�1T Is PO/ Air We- o&ft) /jO( f{ 475 <br />6467- /II< /1)6 - <br />1/U UQ + 7f-Je. LOT Be wnNc T�"- we_ /UecD TO Ch{AN6-�. <br />LOT !.i //725 70 ,)El) 77) 774E LOT 070' ON rite. Cuc.sT cS /D2. <br />ltd Pzg� <br />or /0' C72/ue uy &sxs ernen)?- 3 #97 ies At-so ar' 7a <br />T Theaur -7-H - z or 7v /nttr 6e.Ts-#9-e4 AQ u/gem @W O' - <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 />4,(Aga4 <br />(Signatur?Doa AApplicjaAt) (Date) <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner Page G canaa <br />