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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 597 <br />PAID 2-CZ <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 l74kN1eLT` PP---W 4g.04 <br />(Name) <br />eat 1 1 __1a ILLe �I I <br />(Address) L4,_- gq-b3(Phone) <br />Owner 'I N (' —V ) zn-24) P- P • z� / - i {\l c I zz <br />(Name) (Address) (Phone) 4.5Zs'l i Lo\ <br />Property Location (Street Address and Legal Description): <br />z 2�O Pe ktrar <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />PAID <br />UN OF LITII.F. Mi N <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 p',: k statements received from the City pertaining to additional applica- <br />tion expense. <br />(Signature of Applicant) <br />WHITE— Office CANARY— Customer PINK —Fife GOLD — Planner <br />(o--/g -9z <br />Page 29 (Date) <br />