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Little Canada, Minnesota <br />APPLICATION FORM <br />N° 597 <br />PAID 1D <br />Rec. No <br />Comprehensive Plan Amendment %C Conditional Use Permit <br />Zoning District Amendment Variance <br />Text Amendment Subdivision <br />Other Planned Unit Development <br />Plan Review <br />Applicant P e T` I y-- i-} ✓2� i i�j _ ta) erstr I LLe �( <br />(Name) (Address) 145.4.--04--D3(Phone) <br />Owner P) L_ L_ PAM a 2 � -CcN C& I ZZ <br />(Name) (Address) (Phone) Z _qi lo I <br />Property Location (Street Address and Legal Description): <br />la <br />Description and /or Reason for Request (Cite Ordinance Sections): <br />t ism D( _A�s <br />vivo" <br />JuN is 1532 <br />CM OF LII1LC ChlifOR <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 pT\ � statements received from the City pertaining to additional applica- <br />tion expense. <br />4 <br />11+ • <br />Page 17 (Signature of Applicant) <br />WHITE — Office CANARY — Customer PINK —File GO LD—Planner <br />(Date) <br />