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c <br />Little Canada, Minnesota <br />APPLICATION FORM <br />PAI D <br />N° 584 <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 />Applicant J 0S FPh <br />O 610-/ 3 /3-0 spa4, Si <br />(Name) (Address) <br />Owner G / <br />(Name) <br />"oil 6S)e- <br />3 /3—e SPaggCe <br />(Address) <br />Property Location (Street Address and Legal Description): <br />4'V -9373 <br />(Phone) <br />3160 s PaRuc( S?- A /TTLr c4r'In <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />GI s e e9 <br />CAce SALCS • Ay f%ze! <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 />Page 39 ���� <br />(Signa e of Applicant) <br />WHITE— Office CANARY— Customer PINK —File GOLD — Planner <br />(Date) <br />