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Applicant <br />Owner <br />Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N° 564 <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 <br />. <br />(Name) <br />L3R Dr-.,Q,sQ ;;Ile 3 15S6- <br />(Address) (Phone) <br />(Name) <br />(Address) (Phone) <br />Property Location (Street Address and Legal Description): L\33 2. L'. t41e C4„, - .1,_ Q.J. <br />-1-1-,,,A. c_ -1 -0,;, trc_c_1- 04 \c.—j ;,n tlne Soul, west- G.v<.r }er <br />1 LL 7.(-2; 1 ('� 0�4 the So„ttiW :.} <br />Quo -Her G§- Se cT; on V f wins�:.F 2-.x'1 N()i l ) Kan. e ZZ 13Q - \Dotnit-I 0i, tke <br />'IV \oy1t'ke s� +1.1 11; v,¢ d4 sled -;on 5 i C�n.l('tke 5eo,.s4 b./ i'he e4si 1;*le_ 104 <br />\ 'le SOU 1'1 we�� GVwt -lee O% 4. "le se0l l41 e'S A- QucktiNf` U% Se�4:0.� ; 0h i�'1Q <br />vtoccT.-t-1n1 10\( Ge vo-∎'y Ceee1 <i 50- ca\ \eJ(l�c,.v.1c a1 on 1-ke '/`res-I by -t.ke eo- sberly lirtz <br />U` ? Ott 3i, .u■ VJ4T2r Gitbp s R i 5vt as, — \o-,/ <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />Oav;c\; Pco?v-r *7 <br />clue o sae o� 2 5%on7 <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 />WHITE— Office CANARY— Customer PINK —File GOLD—Planner <br />of Applicant) <br />Page age 7 0 <br />• 3JU(9/ <br />Date ) <br /><4eeO�io <br />