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N° <br />Little Canada, Minnesota PAID <br />APPLICATION FORM <br />Comprehensive Plan Amendment / Conditional Use Permit <br />581 <br />75 <br />Rec. No <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant laTDUCIOFX—`- PP(P i ‘9r1-V ( `(9Q --- 3ICs- <br />(Name) (Address) (Phone) <br />Owner (% P—t( E $'( 111- <br />(Na e) <br />Property Location (Street Address and Legal Description): <br />Jg- 2 -ICE <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />%III 2 - 11 <br />011 a 11Ilt.E CANADA <br />CUP (a P1/4-L}--OW fkU N frc- <br />t'- 77 nt.StJcT- <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. p ^ „ + <br />I I - 21--9 I <br />(SignatureF9 A„pplisnt) (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLD — Planner �J ee LL .,,).@ <br />