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N9 589 <br />Little Canada, Minnesota PAID 7cin <br />APPLICATION FORM 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 - Fc-)cmc-N �1 c ='. -2Ar -N '7 t cz s ED. <br />Owner <br />(Name) <br />(Name) <br />(Address) <br />.a <br />4� -443z� <br />(Phone) <br />Property Location (Street Address and Legal Description): <br />%Ili_ 1GF_ ST C.- 'NAt\ <br />(Address) <br />(Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />n'ymmr SR,r F\ ,j� ■�P\ q� --1 e- c'' <br />PA <br />APR c5.: <br />DEIJITZECANADA <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 />(Signature of Applicar t a g e 22 (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLD — Planner en C) <br />