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Little Canada, Minnesota <br />APPLICATION FORM <br />PAID <br />N° 587 <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 />�" W 379 -6663 <br />Applicant /Cox//F -e--/% 2» /�'v5CV/r 353 /lase /N L44rC4 » y ys3 -b'o /7 <br />(Name) (Address) (Phone) <br />Owner <br />(Name) <br />Property Location (Street Address and Legal Description): <br />3S 3 4.75e- 2. as <br />(Address) (Phone) <br />.Coil G /friA 7 5i JorF�S // Ae z ,, i'-DH /ic- /e /Th yabtr/tnt- r.) rr/{ <br />A -A7oiu ),v <br />I/41 -F /Ll> <br />'ants C'vuti'r1t A1,w c-'sorAi- <br />Description and /or Reason for Request (Cite Ordinance Sections): <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. 1 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 63 <br />(Signature of Applicant) <br />WHITE — Office CANARY— Customer PINK —File GOLD — Planner <br />3/3/02 -- <br />(Date) <br />