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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 562 <br />PAID J$ ) <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment / Variance <br />Text Amendment ✓ Subdivision <br />Other. Planned Unit Development <br />Plan Review ///n <br />// �� 9,7.2 r /S/win /ice JA/ e. J f1,/' Z. n SS' f6; <br />Applicant /�cw �c, i�C.S /7r �� / /� �c /!; /71r' /=sue ,.. -. v1..,,, s ° <br />(Name) ��it c (Address) /tire, (Phone) <br />Owner '.'<% ^•N .t`-- /7 4 e,$) 41rMQ L r® An,a U/" /PO &C 97jJ 411h/// fa # /r, ' 3 /1 / <br />(Name) // (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />7,‘ r Z c/ tr . /fh r <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />/ lc ')/(/':< <br />/j-9'c/l c [/ •47/..r 27, <br />/ 5 )c p / % OMc /cc ! o ,rl <br />on 5.., If <br />ssYYY""" <br />. u JO/k r.¢ij /oT ! <n �.Ai'< '" } �onsn,c <br />r //T 74vc_ <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 ay all slate rnents eceived from the City pertaining to additional applica- <br />tion expense. <br />WHITE -0 <br />Si. ' ature of Applicant) <br />ce CANARY— Customer PINK —File GOLD — Planner Page 42 <br />31 7 ( <br />(Dat l <br />. to <br />