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Little Canada, Minnesota <br />N° 596 <br />PAID VMO.00 <br />APPLICATION FORM Reic. <br />No <br />Comprehensive Plan Amendment Conditional Use Permit ‘ 00c�0 <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other�2EL M" 1An - t -Na.,s.__ Planned Unit Development <br />�RT <br />Plan Review <br />Applicant h-.7 (TTV.G boetvp M 452) F - CPJ - IZb • D k°ia 1 0011 <br />(Name) (Address) (Phone) <br />v� M I F*t €x , INC- L, I m t C,4 - iAtAi 5 117 <br />Owner S /k ""L f=- <br />(Name) <br />Property Location (Street Address and Legal Description): <br />See en-t-r (-h &a. ) <br />(Address) (Phone) <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />In signing this application, I hereby acknowledge that 1 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 al st ements received from the City pertaining to additional applica- <br />tion expense. <br />Page 58 vC GA,/ <br />(6- 9� <br />nature of Applican (Date)/ <br />WHITE — Office CANARY — Customer PINK —File GOLD —PI. ner <br />