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Applicant <br />Little Canada, Minnesota <br />APPLICATION FORM <br />N9 558 <br />PAID <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment --21C— Subdivision <br />Other Planned Unit Development <br />Plan Review <br />(Name) <br />%/ M y4/6 <br />(Address) (Phone) <br />Owner Pt, Oa -f— Ot 4t, oZ?O 4442h `a Li' 63g <br />(Name) (Address) (Phone) <br />Property Location (Street Address and Legal Description): <br />$i.fuvo�- ) vtee,Y" <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />34, 24- Pte: <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 />124J—D,Q ate__ ?..0-6/ qv — <br />(Signature of Applicant) (D te) <br />WHITE — Office CANARY — Customer PINK —File GOLD — Planner Page 9 ,bio <br />