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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 598 <br />PAID tz <br />Rec. No <br />Comprehensive Plan Amendment Conditional Use Permit Q TeT •v <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant E r/ ik 2ED E rE/Y/Y /1/G (D&4 /53c5 Stt'E ET 6, *e, <br />(Name) (Address) (Phone) <br />,' <br />Owner .Sri na E <br />(Name) <br />Property Location (Street Address and Legal Description): <br />.4/x4 -7 /5!c/ S7`Ree� <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): ''' <br />�0 ��r y/7 /fleV'c4anc'if-2 Q li O J(f j e off `f Ce <br />Score q-%n4 _ fS Ac Irs rq,f /%(t) C(/Sd�iG Pr'f <br />d- aA S ScO re(2 e SPcLe i ink 72ta ctY <br />(Jsep, <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 />6//9/z <br />(Signature •f Applicant) Page n (Date) <br />WHITE— Office CANARY — Customer PINK —File GOLD — Planner .min <br />